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UPMC Children’s GI Division Opens New Gastrostomy Tube Clinic

December 16, 2019
The Division of Pediatric Gastroenterology, Hepatology and Nutrition at UPMC Children’s has formally opened its new gastrostomy tube (G-tube) clinic for children and adolescents who have multiple medical needs related to gastrostomy or gastrojejunostomy tubes. The aims of the clinic are to provide comprehensive G-tube care for a wide range of patients: NICU graduates, young children, and older adolescents who may have a long-term tube placement.

Maria Ines Clavell, MD, is the director of the new clinic. Dr. Clavell is an associate professor of pediatrics with board certifications in gastroenterology and clinical nutrition, and a physician certification from the National Board of Nutrition Support Certification. Dr. Clavell works in concert with pediatric dietitian Stacey Zettle, MS, RD, LDN, to treat patients in the clinic. The combination of GI and dietetics eliminates the need for multiple appointments. Patients and families can have all their needs and questions addressed in a single visit. Currently, the G-tube clinic is offered twice per month with future goals to expand and add days as practice volume increases. 
Comprehensive GI, G-Tube, and Nutrition Support

Be it short- or long-term G-tube placements, Dr. Clavell’s clinic provides multimodal care for G-tube patients, not only accounting for their nutrition needs but also troubleshooting various G-tube issues, such as fit or leakage, when changes or upgrades to tubes are called for, complications of G-tube placement such as tissue granulation or infections, and when it may be appropriate to discontinue tube use and resume or start normal oral feeding.

 “A key element of the clinic is maintaining good nutritional support for patients that can allow them to have the best opportunity to progress with feeding skills, and to take part in occupational and speech therapies to facilitate that process,” says Dr. Clavell.

As a gastroenterologist, Dr. Clavell also can attend to any other underlying GI needs or symptoms faced by this patient population. This includes such issues as gastroesophageal reflux, constipation, diarrhea, abdominal distention, bloating, and other common problems. 

Referrals to the G-tube clinic arrive from numerous services and departments across UPMC Children’s and from outside the area. NICU graduates are frequent referrals, as are some patients from the cardiothoracic surgery program and the extensive transplant programs that have long been a hallmark of UPMC Children’s. Most patients who make their way to the clinic have had their tubes placed at varying times in the past. Dr. Clavell and her team also are working to collaborate more closely with surgical programs at UPMC Children’s in advance of patients having tubes placed to help optimize the long-term outcomes and support these patients ultimately need.

“It can assuredly help some patients greatly if we are more involved earlier in their care process, to plan for their specific needs well in advance of their tube placement. I think we will be able to offer more of this service as our program grows,” says Dr. Clavell.

Referrals and Additional Information

For patient referrals or more information, please call the Division of Pediatric Gastroenterology, Hepatology and Nutrition at 412-692-5180.