The Division of Gastroenterology has numerous clinical research endeavors with over 40 IRBs including studies with inflammatory bowel disease, eosinophilic esophagitis, immunologic disorders causing liver disease, detecting tolerance and managing EBV infection post-liver transplant, managing compliance of adolescence with complex medical conditions like post-liver transplantation, and transitioning of adolescent to adult care.
The Stanford Children's Inflammatory Bowel Disease (IBD) Center is involved in ongoing research through the multi-center collaboration within the ImproveCareNow (ICN) Learning Health System, a quality-improvement registry representing 78 pediatric IBD centers, 590 pediatric gastroenterologists, and over 16,000 pediatric IBD patients in the U.S. and England. Our Stanford Children’s IBD Center and ICN registry efforts has a number of clinical investigations and initiatives (including fecal microbiota transplantation). Supported by NIH NIDDK funding to evaluate cost-effective ways to diagnose and manage IBD, recent work from our Division consists of health services research and comparative effectiveness studies in biological agents, such as infliximab (Remicade) and adalimumab (Humira), which are highly effective but extremely costly pharmacotherapies. Our IBD Center is one of the primary sites for a PCORI-funded multi-center pragmatic randomized trial in mono- vs combination therapy using infliximab and methotrexate. We spearhead numerous collaborative efforts, and lead the nation in expertise and evidence-based experience monitoring fecal calprotectin, a biomarker used among gastroenterologists to non-invasively assess histologic mucosal-level inflammation.
Our clinical research in pediatric hepatology and liver transplantation has led to marked improvement of management of children with severe disease and outcomes following liver transplantation. This has included immunotherapy for acute liver failure caused by T-cell mediate liver injury, oral vancomycin treatment of primary sclerosing cholangitis, improved management of metabolic liver disease and post-transplant EBV infection, benefit of outreach clinic programs to improve post-transplant care, and teen clinic to improve post-liver transplant compliance in adolescents.
Our Nutrition Support Team has found innovative approaches to improve care of children requiring long term hyperalimentation which have included ethanol locks to clear central line infections and omegavan to prevent progressive liver disease caused by the intravenous nutrition.