Center for Intestinal Health and Nutrition Support
The Center for Intestinal Health & Nutrition Support offers a focal point for patients with complex gastrointestinal health problems in need of nutritional support. Patients treated for a variety of conditions can develop temporary or permanent feeding disorders that require intervention to restore and maintain nutrition in the context of their health status. In addition to diet modification support, the Center offers long-term tube and intravenous feeding regimens with total parenteral nutrition (TPN), supervised both in the hospital and at home, as essential components of care to restore health. Once patients are discharged, the Center for Intestinal Health & Nutrition Support continues to provide an integrated, multidisciplinary “team” approach to supervise metabolic monitoring, helping patients to maintain nutritional homeostasis and avoid the serious complications of sepsis, thrombosis, and liver disease.
The Center for Intestinal Health & Nutrition Support also offers Pennsylvania’s only small bowel transplantation programs. This area of gastroenterology is not commonly practiced, with only a handful of centers in the US. The University of Pittsburgh’s 20+ years of experience with intestinal transplantations puts the Center into an elite class in terms of surgical and medical expertise.
The Center’s additional areas of expertise include management of patients with severe and refractory Crohn’s disease, complications of ileoanal reconstruction, complications of gastric bypass surgery, complications of intestinal ischemia, intestinal adhesions, and recurrent partial small bowel obstruction, as well as patients suffering from enteropathies including refractory celiac disease, hypogammaglobulinemia, congenital immunodeficiencies, and intestinal dysmotility.
The Center for Intestinal Health & Nutrition Support is committed to improving nutritional care through basic research translated into clinical practice, and is engaged in a number of ongoing research studies:
- The effect of different types of surgical anastomotic reconstructions on long term intestinal function and clinical status, with a specific focus on end-to-end anastomosis vs. side to side anastomosis
- The relationship between diet, colonic bacterial flora, and colon cancer, specifically among native Africans compared to African-Americans
- The relationship between diet, colonic bacterial flora, and colon cancer, specifically among native Americans in Alaska
- Strategies to prevent central line associated blood stream infections using enhanced catheter cleaning protocols in patients requiring long-term parenteral nutrition in the home
- Strategies to rescue digestive function and nutritional status in the setting of excessive weight loss following gastric bypass surgery
- Using healthcare charge trajectories to phenotype patients on long-term parenteral support
- Prospective investigation of vitamin D and nutritional status in the long-term outcome of patients with inflammatory bowel disease (IBD; Crohn’s disease, ulcerative colitis)
- Prospective investigation of dietary fiber, fruit, fat, sugar, and emulsifiers and long-term natural history in patients with IBD
- Exploration of the interactions between pancreatic exocrine function and dietary intake, with particular reference to interventional tube feeding and intravenous feeding in the management of acute pancreatitis
- Investigation of changes in mucosal function in patients with massive intestinal loss during the 12-month post-resection adaptive period.
Physicians and Advanced Practice Providers
The Center for Intestinal Health & Nutrition Support physicians include:
David G. Binion, MD – Director, Nutrition Support
David Levinthal, MD, PhD
Stephen J.D. O’Keefe, MD, MSc
David C. Whitcomb, MD, PhD
Mandy Crum, PA-C
Gina Kozak, PA-C