Venezia by PVII

Robert J. Shulman, M.D.

Professor of Pediatrics
Baylor College of M ed icine

Texas Children's Hospital Foundation Chair in Ped iatric Gastroenterology
Director, Texas Children's Hospital Nutrition Support Team
Texas Children's Hospital

Maturation and Development of the Gastrointestinal Tract

The overall goal in our laboratory is to delineate the factors, particularly dietary that regulate the development and function of the immature gastrointestinal (GI) tract and the function of the mature GI tract.

Our objectives are to: 1) Develop strategies to maximize function of the immature or impair ed GI tract (e.g., in preterm infants, in patients with short bowel syndrome) and 2) Understand the factors affecting the development and manifestations of recurrent abdominal pain in school-age children.

Studies being carri ed out in preterm infants and/or patients with short bowel syndrome include: a) Testing the ability of hormones present in human milk (e.g., insulin) to accelerate the development and enhance the function of the GI tract in preterm infants; b) Delineating what components of GI function (e.g., abnormalities in gastric emptying, carbohydrate malabsorption) account for the development of fe ed ing intolerance in preterm infants. Our ultimate objective is to r ed uce the morbidity and mortality associat ed with preterm birth as well as short bowel syndrome as they relate to the GI tract.

Studies being carri ed out in school-age children include investigations into differences between children with and without recurrent abdominal pain in relationship to: a) GI function; b) Psychosocial influences; c) Influence of diet on pain symptoms. Our ultimate objective is to understand the physiological and psychological contributions to recurrent abdominal pain in children and develop treatment/prevention strategies for this ubiquitous p ed iatric problem.

Representative publications:

McOmber M, Shulman RJ. Recurrent Abdominal Pain. Nutr Clin Prac [in press].

Kellermayer R, Tatevian N, Klish W, Shulman RJ. Steroid responsive eosinophilic gastric outlet obstruction in a child. World J Gastroenterol [in press].

McOmber M, Shulman RJ. Recurrent Abdominal Pain in Children and Irritable Bowel Syndrome. Current Opinion in Pediatrics [in press].

Czyzewski DI, Eakin MN, Lane MM, Jarrett M, Shulman RJ. Recurrent Abdominal Pain in Primary and Tertiary Care: Differences and Similarities. Child Health Care 2007;36:137-153.

Carter BA, Shulman RJ. Mechanisms of Disease: update on the molecular etiology and fundamentals of parenteral-nutrition-associated cholestasis. Nat Clin Pract Gastroenterol Hepatol 2007;4:277-287.

Thakkar K, Gilger MA, Shulman RJ, El-Serag HB. EGD in Children with Abdominal Pain: A Systematic Review. Am J Gastroenterol 2007;102:654-661.

Shulman RJ, Eakin MN, Jarrett M, Czyzewski DI, Zeltzer LK. Characteristics of Pain and Stooling in Children with Recurrent Abdominal Pain. J Pediatr Gastroenterol Nutr 2007;44:203-208.

Tsou VM, Baker R, Book L, Hammo A-H, Soffer EF, Wang W, Comer GM, et al. Multicenter, randomized, double-blind study comparing 20 and 40 mg of pantoprazole for symptom relief in adolescents (12 to 16 years of age) with gastroesophageal reflux disease (GERD). Clin Pediatr 2006;45:741-749.

Ramirez A, Wong WW, Shulman RJ. Factors regulating gastric emptying in preterm infants. J Pediatr 2006;149:475-479.

Olutoye OO, Shulman RJ, Cotton RT. Mitomycin C in the management of pediatric caustic esophageal strictures. J Pediatr Surg 2006;41:e1-3.

Burr RL, Motzer SA, Chen W, Cowan MJ, Shulman RJ, Heitkemper MM. Heart Rate Variability and 24-hour Minimum Heart Rate. Biolog Res Nurs 2006;7 256-267.

Galpin L, Manary MJ, Fleming K, Ou C-N, Ashorn P, Shulman RJ. The effect of Lactobacillus GG on intestinal integrity in Malawian children at risk for tropical enteropathy. Am J Clin Nutr 2005;82:1040-5.

Spencer AU, Yu S, Tracy TF, Aouthmany MM, Llanos A, Brown MB, Brown M, Shulman RJ, Hirschl RB, DeRusso PA, Cox J, Dahlgren J, Strouse PJ, Groner JI, Teitelbaum DH. Parenteral Nutrition-Associated Cholestasis in Neonates: Multivariate Analysis of the Potential Protective Effect of Taurine. J Parent Ent Nutr 2005;29:337-43

Teitelbaum DH, Tracy T, Auothmany MM, Llanos A, Brown MB, Yu S, Brown M, Shulman RJ, Hirschl RB, DeRusso PA, Cox J, Dahlgren J, Groner J, Strouse PJ. Use of cholecsytokinin-octapeptide for the prevention of parenteral nutrition-associated liver disease. Pediatrics 2005;115:1332-1340.

Shulman RJ, Smith EO, Wong WW. Factors influencing lactose digestion and absorption in the preterm infant. Am J Clin Nutr 2005;81:472-479.

Jarrett M, Heitkemper MM, Czyzewski DI, Shulman RJ. Recurrent abdominal pain in children: forerunner to adult IBS? J Spec Pediatr Nurs 2003;8:81-89.

Shulman RJ, Phillips SM. Parenteral nutrition in infants and children. J Pediatr Gastroenterol Nutr 2003;36:587607.