The clinic staff provides multi-disciplinary patient-centered care both in the hospital and on an outpatient basis. Care is optimized with the staff’s close interaction with anesthesia, radiology, pathology, and nutrition services. “When we have an outlying objective and specify what a patient needs, all the caregivers work toward the same outcome,” says gastroenterologist Kirk Thame, MD, who leads the clinic along with Mike Chen, MD, chief of surgery at Children’s of Alabama. “Specialized staff and equipment for these problems also improve outcomes.”
The clinic staff treats common colorectal conditions that include anorectal malformations, Crohn’s disease, fecal incontinence, Hirschsprung’s disease, inflammatory bowel disease, liver and small bowel transplants, motility disorders, familial polyposis syndromes, short bowel syndrome and ulcerative colitis. But the two most common conditions they treat are constipation and encopresis.
“From a medical aspect, many physicians in the community and academic centers don’t focus on kids with constipation and encopresis. They think you can treat the problem with one medication,” says Chen. “These children need to be assessed carefully, because these conditions can be life-altering and sometimes require follow up throughout a patient’s life.”
Chen says that many teens come to the clinic because they soil themselves. “This is tough to endure, and many have had 10 years of that with no help. We provide a bowel regimen, and they become clean,” he says. “Some patients come to us with underlying surgical or medical problems, and they need concentrated management of care. We provide a lifeline to families, because we are geared to the best management strategy, and that is much better for the patients.”
In addition to medical and surgical staff, clinic nurses are available to talk to parents about medications and the child’s care management plan. The specialized equipment also enhances treatment for these young patients “We can x-ray a patient’s bowels to see how a treatment regimen is working,” Chen says. “We also do sensitive diagnostic studies of muscular function to determine if surgical intervention or additional medications are needed.”
Thame says that the cooperative effort among the different staffs helps the care givers as well as the patients. “This approach simplifies patient care for the doctors and other staff because everything can be dealt with in a single visit. We all can do a better job when we are focused on one specific group of problems,” he says. “Overall, the most satisfying thing is to see the positive patient outcomes.”
Chen agrees. “I am proud to be part of a team that can help these kids become ‘clean.’ That can’t be overstated,” he says. “They become like family at our clinic and don’t want to be seen by anybody else. We can change their lives, and that is the most fulfilling thing.”
The Pediatric Colorectal Clinic takes referrals from primary care physicians, and Chen says they are happy to work with these doctors. “We work with them to co-manage a patient’s care, and we let the primary care physician continue to be the primary care giver. We will not take that away. We just want to give these patients access to specialized treatment to deal with their problems.”
Thame says the clinic is still early in its development, but they already are receiving positive feedback from families. “One parent told us, ‘We feel like we have finally found doctors who understand.”
Chen says their ultimate goal is to repair congenital malformations and to treat chronic conditions in order to achieve the best possible results for patients and their families to not only function in life but to enjoy it, too. “We provide an environment where complex colorectal disorders can be assessed and managed medically and surgically,” he says. “Proper care of these problems can change a child’s life.”
