Neurogastroenterology & Motility Center
The University of Pittsburgh Medical Center’s Neurogastroenterology and Motility Center combines clinical expertise in evaluation and management of a variety of functional gastrointestinal disorders with innovative research on mechanisms of visceral pain, psychosocial determinants of GI symptom severity, and the neural basis for cerebral cortical influences on GI tract function. The Center also has developed unique clinical collaborations with UPMC physicians in the Neurology Department to enhance the care of patients with GI symptoms that result from neurodevelopmental, metabolic, neurodegenerative and neuroinflammatory conditions.
The Center’s clinical and research activities reflect the evolving concept that functional GI disorders are not due solely to motility disturbances but rather are associated with altered brain-gut interactions, visceral hypersensitivity and, in some cases, disturbances of GI function mediated by mucosal immunological events. The spectrum of functional GI disorders ranges from those associated with characteristic motility patterns, such as achalasia, gastroparesis, and intestinal pseudo-obstruction, to conditions such as irritable bowel syndrome, functional dyspepsia, and cyclic vomiting syndrome, which are better characterized using a biopsychosocial framework. These latter disorders are treated using an integrative medical paradigm, and the Division’s Pittsburgh Program for Gut-Brain Health (PGH) is often is involved in patient management.
The GI Motility Laboratory at UPMC provides support for the Center’s clinical activities. Under the direction of Dr. David Levinthal, the Motility Laboratory performs numerous diagnostic studies including esophageal and anorectal manometry, ambulatory esophageal pH studies using tubeless capsule technology, combined esophageal pH-impedance testing, colon transit, and breath H2 studies. The lab also supports wireless whole gut motility capsule testing. These tests are supplemented by clinical evaluations from departments, including gastric and gallbladder emptying (Nuclear Medicine), pelvic floor neurophysiology (Rehabilitation Medicine) and pelvic floor MRI and anal sonography (Radiology at Magee-Womens Hospital).
Center physicians have regional and national expertise in disorders of colonic and anorectal function, stomach function, cyclic vomiting syndrome, and intestinal motility disorders. The Center also serves as a tertiary referral center for patients with refractory irritable bowel syndrome, chronic visceral pain syndromes and chronic intestinal failure.
The Neurogastroenterology & Motility Center’s faculty conducts both translational and basic science research. Primary research themes include:
- Dr. David J. Levinthal conducts basic science research on the neural basis for cognitive influences on GI tract function. He also explores GI motility disturbances and treatment options for multiple sclerosis patients.
- Additional basic science research on Diseases of Gut-Brain Interaction (DGBI) are conducted by Dr. Kathryn Albers and Dr. Brian Davis. Dr. Albers works to determine the intrinsic relationship between target-tissue production of neurotrophic factors and sensory neuron function. Dr. Davis’s research studies the role of growth factors in the development and adult plasticity of the central and peripheral nervous systems.
- Dr. Eva Szigethy studies the psychosocial determinants of GI symptom severity. Under her leadership, UPMC is among the first in the nation to offer Brain Manager, a digital behavioral tool for patients with motility disorders who report symptoms of depression on a Program for Gut-Brain Health (PGH) questionnaire. Brain Manager is an app with a platform housed within the UPMC system, which enables empirically supported therapies (cognitive behavioral and dialectical behavioral) to be digitally available to users on their Smartphones. Brief skill building modules and techniques are delivered via a mobile device with the support of an integrated coach who communicates through asynchronous messaging. This trans-behavioral therapy program offers relaxation, behavioral activation, distress tolerance, cognitive reframing, and mindfulness meditation techniques. Each training session is brief and consists of easy-to-use high quality visual and auditory learning aides. UPMC Brain Manager coaches work with patients via a secure coaching portal, and these coaches personalize the content of the therapy modules based on patient’s initial mental health presentation and progress through the program.
- Drs. Levinthal and Szigethy are also partnering with Carnegie Mellon University, which is creating new multimodal fusion algorithms to identify biomarkers in speech and behavior that are evident during conversation. Discovery of such objective, non-invasive biomarkers will improve the accuracy and efficiency with which mental health disorders are diagnosed and monitored. Patients seen at the UPMC Program for Gut-Brain Health (PGH) may be recruited to participate in this innovative project.
Physicians and Advanced Practice Providers
The following Neurogastroenterology & Motility Center physicians work actively to diagnose, treat, and cure functional bowel diseases:
David J. Levinthal, MD, PhD – Director, Neurogastroenterology & Motility Center
Steven R. Abo, MD
Michael Kingsley, MD
Michael Pezzone, MD, PhD
Eva Szigethy, MD, PhD
Eric Golden, MD
Jami Saloman, PhD
Lauren Mazary, CRNP
Samuel Choura, MS, LPC, CHt