7:00am – 8:00am  Meet the Professor Breakfasts (Registration Required)

Hepatitis b y c (in Spanish)
Regino Gonzalez-Peralta MD and Solange Heller MD

Promotion and Career Tracks
Cara Mack MD and Karen Murray MD

Bryan Rudolph MD and Jenifer Lightdale MD

Difficult ethical cases in practice
Stacy Kahn MD and Matthew Ryan MD

Difficult foreign bodies (spinners, pods, batteries, magnets)
Petar Mamula MD and Ben Sahn MD

The nuts and bolts of pancreatic enzymes and EPI
Sohail Husain MD and Alvin Jay Freeman MD

Refractory celiac disease
Ivor Hill MD and Daniel Mallon MD

7:00am – 8:00am  Women in Medicine

Leadership and Diversity
Maria Olivia-Hemker MD, Johns Hopkins University Hospital

Implicit Bias
Gitit Tomer MD, Children’s Hospital at Montefiore 

7:30am - 8:45am APGNN Welcome and Business Meeting


8:00am – 10:15am NASPGHAN Plenary Session

Moderators: James Heubi MD and Karen Murray MD

8:00am Introduction Welcome
Karen Murray MD, President Elect, NASPGHAN

8:05am Keynote Lecture – Personalized medicine in gastroenterology
Judy Cho MD, Icahn School of Medicine at Mount Sinai

Year in Review
Melvin Heyman MD, MPH, Editor JPGN

Business Meeting

Oral abstract presentations

William F Balistreri Lecture - Promise of future health impact of liver organoids
Takanori Takebe MD, Cincinnati Children’s Hospital Medical Center

8:45am - 9:30am  APGNN Session I - The Opioid Crisis and the Effect on Patients and Families

Suzan Blacher MSN, RN, CARN, President, Addiction Nursing Certification Board  International Nurses Society on Addiction, Assistant Professor, RN-BSN Completion Program, Drexel University
Learning objectives:
1. Identify the scope and current state of the opioid crisis in the U.S
2. Describe how the opioid epidemic effects children and families
3. Explore the important roles and responsibilities of nurses in combating opioid abuse

9:30am - 10:00am APGNN Session II- NAFLD

Nicole Triggs, MSN, APRN, CPNP, CPN, Gastroenterology, Hepatology and Nutrition Baylor College of Medicine/Texas Children's Hospital
Learning objectives:
1. Discuss the natural history of NAFL and NASH
2. To implement the recommendations from the NASPGHAN’s 2017 Clinical Practice Guidelines

10:15am – 10:30am BREAK

10:30am - 12:00pm NASPGHAN Concurrent Session I
Stop BUGGING me: Pathogenic bacteria in pediatric gastroenterology
Moderators: Nikhil Pai MD, McMaster University and Sonia Michail MD, Children’s Hospital of Los Angeles

10:30am H palooza 2018 - What's a doc to do?
Mark Gilger MD, Children’s Hospital of San Antonio
Learning objectives:
At completion of this session, the learner will be able to:
1. Assess who to test / not test
2. Demonstrate how to test
3. Evaluate treatment options

11:00am Novel, non-antibiotic, mechanism-based therapy to treat helicobacter pylori infections

11:12am Clostridium difficile infection; The pediatric perspective
Maribeth Nicholson MD, Vanderbilt University
Learning objectives:
1. Describe current literature surrounding C. difficile epidemiology
2. Discuss recommendations surrounding C. difficile diagnosis and treatment
3. Identify controversies surrounding C. difficile colonization and disease

11:42am Fecal microbiota transplantation for recurrent clostridium difficile infection in children: Sustained species level, antimicrobial resistance and pathogen microbiome changes
Suchitra Kaveri Hourigan MD, Pediatrics, Inova Translational Medicine Institute, Pediatric Specialists of Virginia, Johns Hopkins Hospital School of Medicine, Fairfax, VA

NASPGHAN Guidelines and Clinical Reports

Moderators: Melanie Greifer MD, New York University and KT Park MD, Stanford University

10:30am Updates on the management of acute pancreatitis in the pediatric population
Alvin Jay Freeman MD, Emory University
Learning objectives:
1. Understand the process for the creation of these guidelines
2. Review the updated guidelines
3. Describe the limitations of the current guidelines

10:52am NASH/NAFLD
Shikha Sundaram MD, Colorado Children’s Hospital
Learning objectives:
1. To explain the process and rationale for developing the NAFLD guidelines
2. To review the current NAFLD guidelines and their limitations

11:14am Intestinal failure: Structuring your team
Valeria Cohran MD, Ann and Robert Lurie Children’s Hospital
Learning objectives:
1. Describe the essential components of an intestinal rehabilitation program
2. Review the literature that supports the creation of these multi-disciplinary programs
3. Discuss the treatment advances led by intestinal rehabilitation programs

11:36am Non-hospital based biologic infusions in pediatric inflammatory bowel disease
Elaine Barfield MD, New York Presbyterian/Weill Cornell Medical College
Learning objectives:
1. Understand the rationale behind the trend toward non-hospital based infusions
2. Review patient and provider considerations related to non-hospital based infusions
3. Learn the tools necessary to implement a successful home infusion program

Neurogastroenterology and motility: When to move on…

Moderators: Hayat Mousa MD, University of California, San Diego and Elyanne Ratcliffe MD, McMaster University

10:30am What happens when reflux and vomiting are no longer the bread and butter of GI
Julie Khlevner MD, Columbia University Medical Center
Learning objectives:
1. Discuss when it’s appropriate to refer patients with vomiting and reflux to a motility specialist
2. Discuss available diagnostic tools for esophageal and gastric motor disorders
3. Familiarize with new treatment options for children with upper gut motility disorders

11:00am Enteric glial cell plasticity: Astrocytes, schwann cell, neurons and stem cells all-in-one single cell type
Jaime Belkind-Gerson MD, Children's Hospital Colorado, Aurora, CO

11:12am When to refer with constipation to the motility specialist
Leonel Rodriguez MD, Boston Children’s Hospital
Learning objectives:
1. Discuss when it's appropriate to refer patients with constipation to a motility specialist
2. Discuss available diagnostic tools for constipation: when to perform and what to do with the information obtained
3. Familiarize with new treatment options for children with constipation

11:42am A molecular biomarker predicts clinical outcome in children with ASD, constipation, and intestinal inflammation
Stephen Walker MD, Institute for Regenerative Medicine, Wake Forest University Health Sciences, Winston Salem, NC

Nutrition: The developing microbiome and infant nutrition

Moderators: Marialena Mouzaki MD and Raanan Shamir MD

10:30am Early life gut microbiome and immune development
Eytan Wine MD, PhD, University of Alberta
Learning objectives:
1.  To appreciate the complexity of human infant gut microbiome development
2. To define the impact of nutritional, pharmacological, and lifestyle exposures on the infant microbiome
3. To describe the mutual relationship between the infant gut microbiome and the immune system

11:00am Gut-systemic signaling drives total parenteral nutrition associated injury
Ajay Kumar Jain MD, Pediatrics, Saint Louis University, Saint Louis, MO

11:12am Pre and probiotics for neonates and infants
Jae Kim MD, University of California, San Diego
Learning objectives:
1. To review the contribution of mother's milk on prebiotics and probiotics in newborns and infants
2. To identify the mechanisms of action and prebiotics and probiotics in newborns and infants
3. To describe the clinical benefits of prebiotics and probiotics in newborns and infants

11:42am Use of pancreatic enzymes in short bowel syndrome
Nina Sainath MD, Gastroenterology, Children's Hospital of Philadelphia, Philadelphia, PA

10:30am – 12:30pm Colonoscopy Skills Workshop (Registration required, attendance is limited)

Moderators: Catharine Walsh MD and Douglas Fishman MD

10:30am - 12:00pm APGNN Session III - Team Approach to Disordered Feedings
10:30am - 10:50am Management of feeding disorders 
Nannette Blois-Martin MSN, RN, CPNP: Medical PedzFeedz, PLLC, Center for Pediatric Behavioral Health
Learning objectives:
1. Describe common GI conditions that can lead to feeding disorders
2. Discuss potential side effects of long term use of PPI's and current recommendations for pediatric patients
3. Describe the mechanism of action of cyproheptadine, TCA's, and gabapentin and how they can promote improved feeding

10:50am - 11:10am  Nutritional Management of a child on a restrictive diet
Mary Beth Feuling MS, RD, CSP, CD, Advanced Practice Dietitian, Research and Technology, Children’s Hospital of Wisconsin
Learning objectives:
1. Describe what makes a restrictive diet “restrictive” from a nutrition perspective
2. Recognize how restrictions of the diet impact nutrition status
3. Explain how nutrition can be improved for children on a restrictive diet

11:10am - 11:30am Clinical and radiological assessment of swallow
Kristi Brackett MS SLP-CCC Co-Director UNC Pediatric Feeding Team UNC Healthcare, NC Children’s Hospital
Learning objectives:
1. When to order a swallow study
2. Understanding MBSS vs FEES
3. How to choose the best study for the patient

11:30am - 11:50am Avoidant/Restrictive Food Intake Disorder
Robert Dempster, PhD, Pediatric Psychologist Nationwide Children’s Hospital, Program Director, Comprehensive Pediatric Feeding Program & Parker L. Huston, PhD, Pediatric Psychologist, Nationwide Children’s Hospital Comprehensive Pediatric Feeding Program
Learning objectives:
1. Identify core symptoms of ARFID in the pediatric population
2. Describe common behavioral and cognitive interventions for ARFID
3. Understand the role of multidisciplinary team evaluation and treatment of ARFID  

12:00pm – 2:00pm Poster Session II

12:00pm – 2:30pm Hands on Endoscopy  

Organizer: Marsha Kay MD 

2:00pm - 2:30pm APGNN Session IV - Eosinophilic Esophagitis

Chris A. Liacouras, M.D. Professor of Pediatrics, Children’s Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA
Learning objectives:
1. Understand the history, pathophysiology, clinical presentation and diagnosis and therapy of EoE
2. Understand the new AGREE recommendations
3. Understand possible future diagnostic techniques and therapies

2:30pm – 4:00pm  NASPGHAN Concurrent Session II
Inflammatory bowel disease

Moderators: Jeremy Adler MD and Lindsey Albenberg MD

2:30pm Hepatobiliary issues of IBD
Mark Deneau MD, University of Utah
Learning objectives:
1. Understand the prevalence and prognosis of primary sclerosign cholangitis in inflammatory bowel disease
2. Understanding the treatment options for primary sclerosing cholangitis

2:52pm IBD distress vs depression: Are they different and does it matter?
Michael A Harris PhD, Oregon Health & Science University
Learning objectives:
1. Identify the emotional side of IBD
2. Differentiate between IBD-distress and depression
3. Separate fact from fiction regarding depression and IBD based on data and empirical evidence

3:14pm Pediatric PSC-IBD: Elucidating the phenotype, optimizing monitoring strategies and validating novel endoscopic tools
Amanda Ricciuto MD, Gastroenterology, Hospital for Sick Children, Toronto, ON

3:26pm Surgery in IBD
Stacy Kahn MD, Boston Children’s Hospital
Learning objectives:
1. Learn about the risk factors and indications for surgery in pediatric IBD
2. Review the role of medical management in the perioperative period
3. Understand outcomes in the surgical management of pediatric IBD

3:46pm Efficacy of combination antibiotic therapy for refractory pediatric inflammatory bowel disease
Jessica Breton MD, Gastroenterology, Children's Hospital of Philadelphia, Philadelphia, PA

Liver transplant

Moderators: Ruben Quiros MD and Saeed Mohammad MD

2:30pm Approach to the ecosystem of pediatric liver transplant: The pediatric hepatologist perspective
Evelyn Hsu MD, Seattle Children’s Hospital
Learning objectives:
1. Understand the general principles of caring for children before and after liver transplantation
2. Identify challenges facing children in the world of liver transplantation and organ allocation
3. Compare international perspectives on care of the liver transplant patient

2:52pm Tolerance:  We’ve come a long way baby!
Sandy Feng MD, University of California, San Diego
Learning objectives:
1. Evaluate pediatric liver transplant recipients to determine who might be considered for immunosuppression minimization or withdrawal
2. Explain the likelihood of successful immunosuppression withdrawal to patients and their families
3. Identify risk factors that favor successful versus failed immunosuppression withdrawal

3:14pm Improved outcomes of pediatric liver transplant recipients with addition of basiliximab induction therapy
Amrita Narang MD, Pediatric Gastroenterology, Keck School of Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA

3:26pm Adherence and self-management across the pediatric and adult health care continuum
Michele Maddux PhD, Children’s Mercy Hospital
Learning objectives:
1. To summarize the prevalence and common barriers of adherence in pediatric GI disorders
2. To review research on current adherence practices of pediatric gastroenterologists and relevance to transition
3. To describe challenges associated with adherence and self-management across the pediatric and adult health care continuum
4. To review the application of evidence-based strategies to promote adherence during transition

3:46pm Center variation in management of metabolic syndrome in pediatric liver transplant recipients
Kelly Hilk MD, Wayne State University, Detroit, MI

Complementary medicine: “POT”-pourri

Moderators: Maria Perez MD and Ann Yeh MD

2:30pm Cannabis and IBD: Dude, it's really happening  
Edward Hoffenberg MD, Colorado Children’s Hospital
Learning objectives:
1. Develop your own approach to discussing cannabis use with your patients
2. Apply your new understanding to interpretation of future publications about medical use of cannabis products

3:00pm NADPH oxidase and aquaporin-3 dependent redox signaling in intestinal epithelial cells alters NF-KB-mediated pattern recognition receptor responses
Jay Thiagarajah MD, Gastroenterology, Boston Children's Hospital, Boston, MA

3:12pm Complementary therapies in GI disease
Maria Mascarenhas MBBS, Children’s Hospital of Philadelphia
Learning objectives:
1. Describe commonly used complementary therapies in patients with GI disease
2. Learn about the evidence to support the use of complementary therapies in patients with GI disease

3:42pm Continued statural growth in older adolescents and young adults with Crohn's disease and ulcerative colitis beyond the time of expected growth plate closure
Neera Gupta MD, Pediatrics, Weill Cornell Medicine, New York, NY

Endoscopy: Diagnostic endoscopy

Moderators: Kenneth Ng DO and Elizabeth Utterson MD

2:30pm Quality in endoscopy: The road forward
Catharine Walsh MD, Hospital for Sick Kids
Learning objectives:
1. Discuss potential key performance indicators (KPIs) for pediatric endoscopy
2. Understand the relationship between KPIs and quality
3. Appreciate the limitation of KPIs in relation to assessment of competence of the individual
4. Discuss the need for faculty upskilling and ongoing assessment of endoscopic skills
5. Identify strategies to help endoscopists maintain and improve their skills

3:00pm The utility of surveillance endoscoy to diagnosis and monitor esophagitis in patients with esophageal atresia
Michael A. Manfredi MD, Medicine, Boston Children's Hospital, Boston, MA

3:12pm Debate: Role of endoscopy in abdominal pain
To scope: Craig Friesen-MD, Children’s Mercy Hospital vs. not to scope: Miguel Saps MD, University of Miami
Learning objectives:
1. Be able to assess the diagnostic yield and costs of endoscopy in children with abdominal pain
2. Have an understanding of the role of endoscopy in identifying biologic contributors to abdominal pain in the absence of identifiable disease

3:42pm Assessment of fluoroscopy utilization during pediatric endoscopy
Karen Queliza MD, Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA

Functional gastroenterology

Moderators: Armando Madrazo de la Garza MD and Jose Cocjin MD

2:30pm Updates on functional dyspepsia
Adrian Miranda MD, Medical College of Wisconsin
Learning objectives:
1. Review diagnostic criteria for functional dyspepsia in children and its relevance to clinical practice
2. Understand potential targets for therapy
3. Review the evidence to support common treatment options

3:00pm Duodenal expression of sodium voltage-gated channel alpha subunit 3 (SCN3A) and phospholipase A2 group B1 (Pla2-gb1) is increased in children with functional dyspepsia and a lower pain buden
Jasmeet Mokha MD, Pediatric Gastroenterology, Hepatology and Nutrition, Connecticut Children's Medical Center, Hartford, CT

3:12pm Functional GI disorders: Sharing the diagnosis and creating a successful patient/physician alliance
Julie Snyder PsyD, Boston Children’s Hospital
Learning objectives:
1. Demonstrate the ability to utilize specific language, reflection, and other communication skills in order to establish rapport, validate symptoms, and increase compliance with a recommended multidisciplinary treatment approach
2. Integrate the use of metaphors to describe and to explain a functional gastrointestinal diagnosis

3:42pm Esophageal squamous cells from eosinophilic esophagitis patients express a non-gastric proton pump, and their th2 cytokine-stimulated secretion of Eotaxin-3 can be blocked by a potassium-competitive acid blocker and a histmaine H2-receptor antagonist
Eunice Odiase MD, Center for Esophageal Research, Department of Gastroenterology, Baylor Scott and White Research Institute, Dallas, TX

Nutrition: Restrictive diets: Can’t eat, won’t eat

Moderators: Mark Fishbein MD and Justine Turner MD, PhD

2:30pm Nutritional implications of medically prescribed diets
Sally Schwartz BS, RD, CSP, LPN, Ann and Robert Lurie Children’s Hospital
Learning objectives:
1. Address micro and macronutrient risks of medically prescribed diets
2. Discuss managing therapeutic diets to ensure nutritional adequacy
3. Considerations for laboratory and anthropometric monitoring in children with restrictive diets

3:00pm A prospective assessment of food protein-induced allergic proctocolitis from the GMAP healthy infant cohort
Victoria Mackenzie Martin MD, Pediatric Gastroenterology and Nutrition, Food Allergy Center, Massachusetts General Hospital, Boston, MA

3:12pm Avoidant restrictive feeding intake disorders (ARFID)
Richard Noel MD, PhD, Duke University Medical Center
Learning objectives:

3:42pm Pancreatitis-associated medication use in hospitalized pediatric patients with acute pancreatitis
Lauren Veit MD, Gastroenterology, Boston Children's Hospital, Boston, MA

2:30pm - 4:00pm  APGNN Session V - Journey of the Pancreas Patient from the Medical/Surgical Pathways to Outcomes

Learning objectives:
1. Understand the need for multidisciplinary care and the surgical/medical management including care coordination for positive outcomes

2:30pm - 2:50pm Medical management of the pancreas
Maisam Abu-El-Haija, MD Associate Professor of Pediatrics, Medical Director, Pancreas Care Center, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center

2:50pm - 3:10pm Surgical Management
Jaimie D. Nathan, MD, FACS Associate Professor of Surgery and Pediatrics, Surgical Director, Pancreas Care Center, Division of Pediatric General & Thoracic Surgery, Cincinnati Children’s Hospital Medical Center

3:10pm - 3:25pm Post-Op inpatient surgical management
Stephen Mark Ogg, MSN, RN, FNP-C General Surgery Nurse Practitioner, Division of Pediatric General & Thoracic Surgery, Cincinnati Children’s Hospital Medical Center

3:25pm - 3:40pm Care coordination
Angela M. Turner, MSN, RN, CPN: Registered Nurse III Pancreas Care Center, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center

3:40pm - 3:50pm Program management- systems and processes
Lari Neal, MS, BSN, RN, CCM, CPN, Program Manager, Pancreas Care Center Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center

3:50pm - 4:00pm Questions and answers

4:15pm – 5:30pm NASPGHAN Awards Ceremony

Moderators: James Heubi MD and Barry Wershil MD

James E. Heubi, MD, President, NASPGHAN

Presenter: Carlo Di Lorenzo, MD
Awardee: John Barnard A. Barnard, MD

Presenter: David Brumbaugh, MD
Awardee: Michael R. Narkewicz, MD

Presenter: Binita Kamath, MD, MBBChir, MRCP
Awardee: David A. Piccoli, MD

Presenter: Laurie Fishman, MD
Awardee: B UK Li, MD

Barry Wershil, MD
President, NASPGHAN Foundation

Gerard Odell Prize – Dennis D. Black, MD
Richard J. Grand and John B. Watkins Prize – Diana Montoya Melo, MD
Teri Li Award – Diana Lerner, MD


4:15pm - 5:15pm  APGNN Session VI - Are you smarter than a 5th grader?

Norberto Rodriguez-Baez, MD University of Texas Southwestern Medical Center
Learning objectives:
1. Know diagnostic and radiological studies used in common gastrointestinal diseases
2. Understand the mechanism of action of common medications used in pediatric gastroenterology and hepatology

3. Describe different pathogens causing diseases in the gastrointestinal tract

5:15pm - 6:00pm  APGNN Conference wrap up and committee meetings

6:00pm   APGNN Social Event
6:00pm   CPNP Social Event

Debate:  H pylori ESPGHAN guidelines vs reality in Latin America  
Paul Harris MD Pontificia Universidad Catolica de Chile -  Reality in Latin America
Juan José Díaz Martín MD Hospital Central de Asturias  - ESPGHAN Guidelines

Oral abstract presentations


Advanced Diagnostic Hepatobiliary Endoscopy in Pediatrics
Roberto Gugig MD, Children’s Central California

Debate - Liver transplant in pediatrics: Controversies and challenges
Daniel D’Agostino MD, Hospital Italiano de Buenos Aires vs. Norberto Rodriguez Baez MD, UT Southwestern Medical Center