Gastroenterology, Hepatology & Nutrition

Dr. Kevan Jacobson, Division Head

Dr. Kevan Jacobson, Division Head

The Division of Gastroenterology entered the new millennium with a fresh vision for its future and major recruitment initiatives underway. Thanks to the dedicated work of the Children with Intestinal and Liver Disorders (CH.I.L.D.) Foundation and its fundraising efforts in recent years, the Division is realising its goal of developing an outstanding program in basic science research in pediatric gastroenterology. This will complement the existing strengths in clinical care and education. Learn More

 

 

 

 

 

 

All members of the division of Pediatric Gastroenterology, Hepatology and Nutrition division share the vision of improving the lives of children with intestinal and liver disorders. Research is an integral step towards this vision and as part of our clinical and academic mission, our team of physicians, nurses and scientists are active involved in clinical, translational and bench research. The division has a long history of clinical care and research, with the main focus of the program being in the areas of inflammatory bowel disease (IBD), liver disorders acid peptic disease and celiac disease. More recently the division added complex feeding and nutrition and eosinophilic esophagitis (EoE) as focused programs. The division together with Child Health BC has also established an outreach and telehealth program, bringing care directly to patients and families within their communities.

Dr. Kevan Jacobson is the Division Head, Senior Clinician Scientist and Director of the pediatric GI IBD program. Dr. Jacobson is involved in clinical care of children with IBD and in clinical and basic research in the field of IBD. He oversees the Pediatric GI IBD database, which currently has data on over 1200 children. Dr Jacobson’s clinical areas of interested include the epidemiology of IBD, identifying new diagnostic and therapeutic strategies and improving clinical outcomes for children with IBD. He is a deputy co-Chair of the CH.I.L.D/ CIHR funded National Pediatric IBD Inception Cohort Initiative

Dr. Richard Schreiber is the division’s senior liver specialist and Director of its pediatric liver transplant program. His clinical research interests include biliary atresia, pediatric viral hepatitis B and C, autoimmune hepatitis and liver transplant. He is co-founder of the Canadian Pediatric Hepatology Research Group, a national collaborative effort to research and help improve the care and outcome of Canadian children with liver disease. He is the lead investigator of a CIHR funded project examining the feasibility of a home based newborn screening program for biliary atresia using infant stool colour cards. Dr Schreiber is co-director of the Canadian Biliary Atresia Registry (CBAR). Dr Schreiber was elected President of the Canadian Association for the Study of the Liver (CASL) (www.hepatology.ca) in 2016.

Dr. David Israel’s areas of interest include the diagnosis and epidemiology of celiac disease and IBD and optimizing the treatment options for these diseases. He currently focuses on quality assessment, quality improvement and ethical issues and dilemmas in pediatrics and pediatric GI, as well as optimizing the decision making process for providing care for pediatric patients.

Dr. Collin Barker’s research interests focus on celiac disease, GI complications in oncology patients and quality assessment and quality improvement projects within the division of pediatric gastroenterology, hepatology and nutrition.

Dr. Orlee Guttman is interested in education and in clinical research. Dr Guttman is currently studying the role of FibroScan (transient elastography) in evaluating the extent of liver fibrosis in children with primary liver disease and other disorders. She is also involved in studying non-invasive measures of cystic fibrosis liver disease. Dr Guttman recently took over the role of GI Fellowship program Director from Dr Barker

Dr. Vishal Avinashi is involved with the EoE clinic together with Dr. Edmond Chan (Allergist). They are presently running a pilot study to evaluate less invasive ways of monitoring EoE. Dr Avinashi continues to be involved in the intestinal rehabilitation (CHIRP) and complex feeding programs and has been involved in the development of the innovative Steps to Feeding program, the only intensive enteral tube weaning program in Canada. He also has a strong interest in public health nutrition locally and internationally.

Dr Linda Casey is the Director of the Complex Feeding and Nutrition program at BC Children’s Hospital. Dr Casey has a strong background in clinical nutrition, in the care of children with short bowel syndrome, and has interests in education and quality assessment and quality improvement projects. Dr Casey together with Dr Avinashi and Dr S. Butterworth (Pediatric General Surgeon) established the inpatient intestinal rehabilitation program in 2013.  This complements the established neonatal intestinal rehabilitation consult service and outpatient intestinal rehabilitation program to provide a comprehensive state of the art intestinal rehabilitation program. Dr Casey is responsible for the integration of nutrition into the renewed curriculum for the UBC School of Medicine and is developing innovative approaches to integrating nutrition into the medical curriculum.  In early 2016, she accepted the position of Vice President of the C&W Medical Staff Association, and is leading the implementation of the Medical Staff Engagement Project at BC Children’s Hospital and BC Women’s Hospital.

Dr Sally Lawrence is the newest member of the GI division having joined the Division in April 2015. Dr Lawrence has extensive experience in the care of children with IBD and liver disorders. Dr Lawrence’s interests include enhancing quality of care for children and specifically for those children with IBD through quality improvement initiatives.  Dr Lawrence is evaluating the uptake and efficacy of vaccinations in children with IBD.

In 2000, the Division initiated a plan to develop a strong basic science research program that would integrate with and complement the clinical strengths and interests within the Division. In 2002, this plan led to the establishment of an endowed chair in Pediatric Gastrointestinal and Liver Research at the University of British Columbia, with the support of the CH.I.L.D. Foundation and B.C.'s Children's Hospital. This chair was instituted to become a cornerstone in building the pediatric gastrointestinal (GI) research program in British Columbia. Dr. Bruce Vallance was recruited to the BC Children's Hospital Research Institute (BCHRI) in 2003 and was appointed as the CH.I.L.D. Foundation Research Scholar. In 2008 he was promoted to associate professor and in 2010 became the inaugural recipient of the endowed chair. Dr Vallance was promoted to full professor in 2014. Dr. Kevan Jacobson has maintained a research laboratory at the BCHRI since 1999, and in 2004, was named the CH.I.L.D. Foundation Clinical Investigator. He was promoted to full professor in 2012. In 2008, Dr. Sly was recruited to the division and to the BCHRI as an assistant professor and a CH.I.L.D. Foundation Research Scientist.  Dr. Sly was appointed as a Michael Smith Foundation for Health Research Scholar in 2012 and was promoted to associate professor 2015.

Currently the basic science research program has twenty trainees and staff and the division’s three research laboratories are funded by the Canadian Institutes for Health Research, the Crohn’s and Colitis Foundation of Canada and the National Sciences and Engineering Research Council. All three investigators are actively recruiting postdoctoral fellows and graduate students.

Dr. Vallance’s research is focused on understanding how pathogenic as well as commensal bacteria cause inflammation and disease in the mammalian intestinal tract. He is also studying the active roles played by intestinal epithelial cells and mucus in protecting the intestine from infection and from IBD, as well as developing novel therapies for IBD focused on diet and vitamin D. Dr Vallance and Jacobson’s biomedical research programs include 14 members in the basic science program and an additional three members in the clinical program. Dr Vallance is also the co-Biomedical Lead of the CH.I.L.D/ CIHR funded National Pediatric IBD Inception Cohort Initiative. . For specifics, please see http://www.vangopro.ca/Vallance-Lab/overview.html

Dr. Jacobson studies how intestinal vasoactive peptides modulate intestinal epithelial barrier integrity and promote intestinal health. He is also examining the role of diet in modulating intestinal microbes and epithelial barrier function and how diet affects susceptibility to IBD. The goal of Dr Jacobson’s research is to develop novel treatment strategies that protect the intestine from infection and from IBD. For specifics, please see http://www.vangopro.ca/Jacobson-Lab/overview.html

Dr. Sly studies intestinal macrophages and how different macrophage subsets either drive intestinal inflammation such as occurs in IBD, or promote intestinal healing. Dr Sly’s research is focused on developing novel therapies through studies that block to pathways by which macrophages contribute to inflammation, and by promoting anti-inflammatory macrophages. Sly’s research program includes 6 members.-For specifics, please see http://www.vangopro.ca/Sly-Lab/overview.html

See Vancouver Gastrointestinal Disease Research Program

The Division has a Royal College accredited fellowship training program in pediatric gastroenterology, hepatology and nutrition.  We have developed a formal and extensive educational program for the UBC pediatric residents and medical students.. Medical students and pediatric residents regularly rotate through the Division, and are an integral part of our team.

Members of the Division have leadership roles in the Canadian Association for the Study of the Liver’s Education Committee, in the Canadian Association of Gastroenterology CME courses for GI fellows in Canada and in the Royal College of Physicians and Surgeons Pediatric GI Examination Committee. The Division actively participates in Grand Rounds.
Our division is proud to be part of an academic teaching hospital and takes great interest in teaching and mentoring of trainees at all different stages.

For more information on training opportunities, please see the PEDS GI Fellowship Brochure

The Gastroenterology division provides a compressive clinical service with both inpatient and outpatient care. Each year, the division receives approximately 4000 outpatient visits and 500 inpatient consultations. The division administers the only Pediatric GI Procedure Suite in British Columbia and is responsible for performing over 700 endoscopic and non-endoscopic procedures in children. A complex feeding and nutrition program has been established to address the needs of children with complex feeding and nutritional disorders. Inflammatory bowel disease, hepatology, eosinophilic esophagitis and celiac disease clinics have been established to offer specialized care to children with these disorders. Members of the division participate in a multidisciplinary transplant clinic to provide ongoing management for children post liver transplant. The Division works closely with the Departments of Pathology, Radiology and General Surgery.

The physicians perform endoscopic procedures in the operating room with sedation provided by anaesthesiologists.

Procedures include:

  • Upper endoscopy with biopsies
  • Colonoscopy with biopsies
  • Balloon dilatation
  • Esophageal banding / Sclerotherapy
  • Polypectomy
  • Foreign body removal

Non endoscopic procedures include pH/ Impedence studies which help evaluate acid and non-acid reflux, esophageal motility which evaluates how the esophagus contracts and empties and anorectal manometry which evaluates the function of the anal sphincter and rectum. These procedures do not require sedation.

Faculty:

Vishal Avinashi, MD, FRCPC
Collin Barker
, BSc, MD, MSc, FRCPC
Linda Casey, MD, FRCPC
Orlee Guttman, MD, MHPE, FRCPC
David Israel, BSc, MD, FRCPC
Kevan Jacobson, MB BCh, FRCPC, Division Head
Sally Lawrence, MD, FRCPC
Rick Schreiber, BSc, MD, FRCPC, DAAP
Laura Sly, PhD
Bruce Vallance, BSc, PhD
Simone Nicol, Clinical Fellow
Meshari Alaifan, Clinical Fellow
Jessica Woolfson, Subspecialty Resident

GI Nurses

Kathi Evans, Nurse Clinician, GI Clinic
Tania Ferraro
Lori Lonergan
Marliss Riou
Fran Starr, Complex Feeding and Nutrition Service
Sarah Fay, Transplant Nurse
Jessie Ahuja, Transplant Nurse

Dietitians

Ali Boyle, Complex Feeding and Nutrition Service (Victoria Okrusko July 2016-June 2017)
Debby Martins, Complex Feeding and Nutrition Service
Preeti Vekaria, Kirstin Wingate

Occupational Therapy

Rochelle Stokes, Complex Feeding and Nutrition Service (Astrid St. Pierre July 2016-June 2017)

Social Work

Kathryn Urquhart, Complex Feeding and Nutrition Service

Administrative Staff

Agnes Lopez, New Patient Booking Secretary
Vikki Biring, Follow up Patient Bookings / Clinic Secretary
Cheryl Lockman, Complex Feeding and Nutrition Service
Genevieve Mills, Endoscopy Booking