Gastroenterology, Hepatology & Nutrition

Dr. Vishal Avinashi, Division Head

The Division of Gastroenterology, Hepatology and Nutrition offers outstanding clinical care, education to patients and health care practitioners along with a dynamic program in basic science / translational research. [Learn More]

UPDATED Mar 26 2021
 
 
 
 
 

 

 

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, Eosinophilic Esophagitis, and celiac disease. Complex Feeding and Nutrition service offers a novel outpatient program related to tube weaning / dependency. 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 a 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 has recently completed his term as president of the Canadian Association for the Study of the Liver (CASL).

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 is the fellowship program director.

Dr. Vishal Avinashi is co-director of the EoE clinic together with Dr. Edmond Chan (Allergist). Research interests include evaluating risk factors, response to treatments, and non/less invasive ways to diagnose and follow 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, one of the original intensive outpatient 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. Dr. Casey is presently the 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. Lawrence has extensive experience in the care of children with IBD. 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 a recipient of the prestigious Hudson’s Scholar which will allow her to evaluate the uptake and efficacy of vaccinations in children with IBD.

Dr. Andy Skinn’s primary focus relates to the Pediatric Gastroenterology Outreach program, providing clinical care to patients on Vancouver Island and Interior BC. Academic interests include a quality improvement initiative to improve the referral and triage process to further enhance the care we are able to provide through the Outreach program.

Dr. Jocelyn Jeong's interest is in clinical epidemiology. Her past and current projects include studying the global incidence of celiac disease and the ethnic variation of pediatric inflammatory bowel disease within Canada. She has also undergone formal training in dedicated bowel ultrasound and is internationally certified through the International Bowel Ultrasound Group. Her current research focus is the use of bowel ultrasound to monitor the effects of medical therapy on bowel wall thickness in pediatric inflammatory bowel disease and other pediatric gastrointestinal disorders.

Dr. Alice Foster’s clinical focus is in childhood inflammatory bowel disease. She completed a 2-year advanced fellowship in inflammatory bowel disease through the Royal College of Canada’s Clinician Investigator Program. In addition, she has a Master of Health Science degree focusing on research study design and epidemiology. She has been collaborating with children’s hospitals across Western Canada to improve transition programs for children and adolescents with inflammatory bowel disease as they move to adult care. Dr. Foster has been selected to continue this work by participating in the PHSA Physician Quality Improvement Program.

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.

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.

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.

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 contact Daisy Yin at daisy.yin@cw.bc.ca

To view information on the Pediatric GI fellowship program, please click: PEDS GI Fellowship Brochure Feb 2021

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, MPh, FRCPC, Division Head
Collin Barker, MD, MSc, FRCPC
Linda Casey, MD, FRCPC, Complex Feeding Director
Alice Foster, MD, MSc, FRCPC
Orlee Guttman, MD, MEd, FRCPC, Fellowship Program Director
Kevan Jacobson, MB BCh, FRCPC
Jocelyn Jeong, MD, FRCPC
Sally Lawrence, MD, FRCPC
Rick Schreiber, MDCM, FRCPC
Andrew Skinn, MD, PhD, FRCPC, Outreach
Laura Sly, PhD, Research
Bruce Vallance, PhD, Research

GI Nurses

Rosemary Cooke
Kathi Evans, Outreach
Tania Ferraro
Rhonda Retel
Marliss Riou
Sarah Fay, Transplant Nurse
Jessie Ahuja, Transplant Nurse

Dietitians

Soleina Karamali, Complex Feeding and Nutrition Service
Debby Martins, Complex Feeding and Nutrition Service
Victoria Okrusko
Meagan Vurzinger, Outreach

Occupational Therapy

Rochelle Stokes, Complex Feeding and Nutrition Service

Social Work

Kathryn Urquhart, Complex Feeding and Nutrition Service

Administrative Staff

Deborah Finlay, Administrative Secretary
America Poidevin, New Referral Patient Booking/Enquires Secretary
Vicki Biring, Follow-Up Patient Booking/Enquiries Secretary – Corrected the spelling.
Leah Aniscol, Clinical Secretary
Anita Terjesen, Endoscopy Booking, Complex Feeding & Nutrition Secretary