2019 NASPGHAN Postgraduate Course - Thursday, October 17

Course Directors:

Jennifer Strople MD, MS
Associate Professor of Pediatrics
Northwestern University Feinberg School of Medicine
Program Director, GI Fellowship Program 
Ann & Robert H. Lurie Children's Hospital of Chicago 
Chicago, IL          

Maria Oliva-Hemker MD 
Director, Division of Pediatric Gastroenterology, Hepatology and Nutrition
Stermer Family Professor of Pediatric Inflammatory Bowel Disease
Vice Chair for Faculty Development, Diversity and Promotion, Dept. of Pediatrics
Johns Hopkins University School of Medicine
Baltimore, MD

Module 1: Endoscopy (Speaker slides here)

Moderators: Gary A Neidich, MD, Sanford Children's Hospital and Jennifer Strople, MD, Ann & Robert H Lurie Children's Hospital
8:00am

Management of Foreign Bodies

David Brumbaugh, MD, Children's Hospital Colorado
Objectives:

• Understand epidemiology, symptoms, and management of common gastrointestinal foreign body ingestions in children
• Review new poison control guidelines for pre-hospital and in-hospital management of swallowed button batteries
• Discuss clinical management of high-powered magnet ingestions

8:20am

Advanced endoscopic techniques for gastrointestinal bleeding

Petar Mamula, MD, Children's Hospital of Philadelphia
Objectives:

• Briefly discuss existing techniques for treatment of gastrointestinal (GI) bleeding
• Discuss new techniques available for treatment of GI bleeding
• Discuss endoscopy training in these techniques

8:40am

Cancer screening top to bottom

Srinadh Komanduri, MD, Northwestern Medicine
Objectives:

• Recognize current recommendations for screening for CRC in specific populations and identify novel diagostic tools for screening
• Understand the role of Barrett's Esophagus in development in Esophageal AdenoCA and the role of screening in GERD
• Identify specific populations who need screening for pancreaticobiliary malignancies

12:10pm-1:35pm Learning Lunches

1. Challenging celiac disease cases
   Moderator: Iona Monteiro, MD
   Alessio Fasano, MD, MassGeneral Hospital for Children and Maureen Leonard, MD, MassGeneral Hospital for Children
2. Comprehensive treatment of functional disorders—Difficult cases
   Moderator: Tanaz Danialifar, MD
   Carlo Di Lorenzo, MD, Nationwide Children's Hospital and Rob Shulman, MD, Children's Nutrition Research Center
3. Complicated IBD
   Moderator: Jeanne Tung, MD
   Anne Griffiths, MD, Hospital for Sick Children and David Rubin, MD, University of Chicag
4. Management of chronic cholestasis
   Moderator: Henry Lin, MD, MBA
   Saul Karpen, MD, PhD, Emory University and Sanjiv Harpavat, MD, PhD, Texas Children's Hospital
5. Chronic pancreatitis
   Moderator: Gary Galante, MD
   Sohail Husain, MD, Stanford Children's Hospital and Jaimie Nathan, MD, Cincinnati Children's Hospital Medical Center
6. NERD and Dyspepsia: Real world treatment
   Moderator: Kelly Fair Thomsen, MD, MSCI, CNSC
   Julie Khlevner, MD, Morgan Stanley Children's Hospital and Diana Lerner, MD,  Medical College of Wisconsin
7. Foreign body management in practice
   Moderator: Alex Koral, MD
   David Brumbaugh, MD, Children's Hospital Colorado and Petar Mamula, MD, Children's Hospital of Philadelphia
8. How to approach your patient who wants to use a medical marijuana product
   Moderator: Ellen Mitchell, MD
   Ed Hoffenberg, MD, Children's Hospital Colorado and Ann Ming Yeh, MD, Stanford University-Lucile Packard Children's Hospital
9. Eosinophilic GI disease
   Moderator: Garrett Zella, MD
   Edaire Cheng, MD, UT Southwestern Medical Center and Nathalie Nguyen, MD, Colorado Children’s Hospital

Module 2: Potpourri (Speaker slides here)

Moderators: Terry Sigman, MD, FRCPC, Montreal Children's Hospital and Maria Oliva-Hemker, MD, Johns Hopkins University School of Medicine
9:00am

Celiac disease: Beyond diagnosis

Alessio Fasano, MD, MassGeneral Hospital for Children
Objectives:

• Review current celiac disease diagnostic criteria and critically review the need for an upper endoscopy to confirm diagnosis
• Discuss the best approach to monitor compliance with the gluten free diet
• Provide an overview of ongoing clinical trials aimed at identifying novel target for treatments alternative/complementary to the gluten free diet

9:20am

The role of the gastroenterologist and hepatologist in Cystic Fibrosis (CF) Care today

Meghana Sathe, MD, UT Southwestern Medical Center
Objectives:

• Understand the management of pancreatic replacement enzyme therapy
• Become familiar with Cystic Fibrosis Transmembrane Recepetor (CFTR) Modulators and the potential impact on GI manifestation of CF
• Recognize how to differentiate between Distal Intestinal Obstruction Syndrome (DIOS) and Constipation and understand variations in management

9:40am

Update on C. difficile

Sonia Michail, MD, Children's Hospital Los Angeles
Objectives:

• Understand the manifestations and risks of development of clostridium difficile infection
• Update on treatment of clostridium difficile infection
• Understand options in difficult to treat cases

10:00am

What the pediatric GI provider needs to know about cannabis

Ed Hoffenberg, MD, Children's Hospital Colorado
Objectives:

• Describe how endocannabinoid system modulation may impact GI disorders
• Identify complications and risks of cannabis use
• Develop your own approach to discussing cannabis use with your patients

10:20am-10:40am

Break

Module 4: Liver/Pancreas (Speaker slides here)

Moderators: Nadia Ovchinsky, MD, MBA, Children's Hospital at Montefiore and Jennifer Strople, MD, Ann & Robert H Lurie Children's Hospital
1:40pm

New news in NAFLD

Miriam Vos, MD, MSPH, Emory University
Objectives:

• Understand current concepts in pathogenesis
• Update on diagnostic tools for NAFLD
• Discuss clinical management of pediatric NAFLD

2:00pm

New therapies for chronic cholestatic diseases
Saul J. Karpen, MD, PhD, Emory University School of Medicine/Children’s Healthcare of Atlanta
Objectives:

• Know the array of new agents that target bile acid based hepatotoxicity of cholestatic diseases
• Understand the approach to therapy for genetic forms of cholestatic diseases based upon specific genes and variants—chaperones and potentiators
• Know the current status of the field regarding treatments for biliary atresia

2:20pm

Diagnosing drug-induced pancreatitis

Sohail Husain, MD, Stanford Children's Hospital
Objectives

• Recognize the burden of drug-induced pancreatitis in children and the commonly associated drugs
• Evaluate the causality indices for drug-induced pancreatitis
• Review management guidelines for drug-induced pancreatitis in children

2:40pm

Pediatric pancreatic masses: Steroids, surgery or surveillance?

Jaimie D. Nathan, MD, FACS, Cincinnati Children's Hospital Medical Center
Objectives:

• Recognize the presentation of pancreatic masses in children
• Understand the workup and evaluation of pediatric pancreatic masses
• Recognize the different etiologies and outcomes of pancreatic masses in children

3:00pm – 3:20pm

Break

Module 3: Functional/motility (Speaker slides here)

Moderators: Anil Darbari, MD, MBA, Children's National Medical Center and Maria Oliva-Hemker, MD, Johns Hopkins University School of Medicine
10:40am

Testing for functional disorders: The indispensable, the useless, the dangerous

Carlo Di Lorenzo, MD, Nationwide Children's Hospital
Objectives:

• When testing is needed in the child presenting with symptoms of IBS/FAP
• Emphasize how to effectively provide reassurance in the office setting
• Discuss the dangers and relevance of the incidental findings
• Address conditions which may mimic pain predominant functional disorders

11:00am

Achalasia

Peter Kahrilas, MD, Northwestern Medicine
Objectives:

• Review the sub-classification of achalasia and related syndromes
• Understand the limitations pneumatic dilation and Heller myotomy in treating spastic achalasia (type III)
• Appreciate the advantages and disadvantages of pneumatic dilation, per oral endoscopic myotomy (POEM) and laparoscopic Heller myotomy

11:20am

Evaluation and treatment strategies in NERD and functional dyspepsia

Julie Khlevner, MD, Morgan Stanley Children's Hospital
Objectives:

• Discuss the criteria for diagnosing NERD and functional dyspepsia
• Understand the current concepts in pathogenesis of NERD and functional dyspepsia
• Review evidence based approach to therapy in pediatric NERD and functional dyspepsia

11:40am

Role of diet in Managing of IBS

Robert J. Shulman, MD, Children's Nutrition Research Center
Objectives:

• Describe mechanisms whereby diet can induce symptoms
• Enumerate pros and cons of different diets
• Describe limitations of research on diet therapy

Module 5: Intestinal Inflammation (Speaker slides here)

Moderators: Deborah Neigut, MD, Children's Hospital Colorado and Jennifer Strople, MD, Ann & Robert H Lurie Children's Hospital
3:20pm

Positioning the new IBD therapies: Merging experience with evidence

David T Rubin, MD, University of Chicago
Objectives:

• Choose therapies based on prognosis and confirm effectiveness
• Identify targets of treatment that are individualized based on patient symptoms and objective measures of disease activity
• Understand risks and benefits of considering de-escalation and restart protocols in management

3:40pm

Immunosuppressive therapy in IBD: Can we de-escalate therapy?

Anne Griffiths, MD, FRCPC, Hospital for Sick Children
Objectives

• Advise families concerning the likelihood of (and factors predictive of) successful discontinuation of biologic therapies
• Utilize therapeutic drug monitoring to plan de-escalation of combination therapy with biologics
• Initiate and utilize biologic therapies in a way most likely to allow long-term effectiveness while balancing risks

4:00pm

When it is not IBD…Rare forms of intestinal inflammation

Stacy Kahn, MD, Boston Children's Hospital
Objectives:

• Learn to recognize and diagnose intestinal inflammation not due to IBD
• Understand the natural history of a variety of rare forms of intestinal inflammation
• Learn how to treat rare forms of intestinal inflammation

4:20pm

Eosinophilic inflammation beyond the esophagus

Edaire Cheng, MD, UT Southwestern Medical Center
Objectives:

• Understanding the diagnostic criteria for eosinophilic gastrointestinal diseases (EGIDs).
• Recognizing clinical presentations for eosinophilic gastrointestinal diseases.
• Understanding the relationship between EoE and EGIDs.