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Nurse practitioner Shanda Sandridge and a young patient stare at a video screen, one the little girl is controlling with her body.
“Let's let the blue bird fly higher,” Sandridge said. “Don't let the red bird go up, though.”
Through muscle contractions or relaxation in the abdomen and pelvic floor, transmitted through electronic leads, kids can make birds fly high or low on a video screen. Red birds flying low represent a relaxed pelvic floor, while blue birds soaring upward show abdominal contractions.
The game is a form of biofeedback therapy used to encourage and strengthen muscle coordination as well as confidence. It's one of the features of the Pediatric Gastrointestinal Motility program at Batson Children's Hospital on the campus of the University of Mississippi Medical Center.
Gastrointestinal motility, or the ability for food to be processed by the body, is vital to a child's growth and well-being. Any slow-downs in the path from a child swallowing food to eliminating waste “definitely have the potential to cause life-threatening problems.”
This therapy can help children with nerve or muscular damage from infections or other conditions have a better understanding of how their bodies work and how to use their muscles more effectively, said Dr. Neelesh Tipnis, chief of the Division of Pediatric Gastroenterology at the University of Mississippi Medical Center.
Tipnis and his division solve gastrointestinal problems and their causes at Batson Children's Hospital, one of a dozen spots in the U.S. where advanced pediatric gastrointestinal motility can be tested.
“These problems can start at age zero,” Tipnis said. Some children are born with gastroschisis, or a protrusion of the intestines through the abdominal wall, for example, while others suffer from short-bowel syndrome, which can lead to diarrhea and malnutrition.
Problems can also occur later in a child's life, perhaps the result of a virus attacking the gastrointestinal system, leaving its function weakened or compromised.
“They can cause severe functional disability,” Tipnis said.
No matter when, how or why they begin, pediatric gastrointestinal problems can follow a child into adulthood, Tipnis said.
“A combined bio-social model is critical,” said Tipnis, in treating pediatric gastrointestinal disorders. He teams with Sandridge and Dr. Leilani Greening, psychologist, in treating the whole child, including fears, stress and social phobias relating to what is a process of living and growing.
“Some children can be paralyzed by anxiety” over their disorders, Tipnis said, whether those involve problems in swallowing food to woes in potty training.
Troubles can be exacerbated in the classroom, said Sandridge, when students are not allowed all the bathroom time needed or experience shame, either at school or at home, when accidents happen. That can lead to children avoiding visits to the bathroom.
Using a psycho-social model can give children coping strategies whether their problems are physical or emotional, as treatment takes into account the child's social world, home, school and surroundings. Said Greening: “We're treating the whole child, including the whole family.”
Testing to pinpoint problems includes anorectal manometry to evaluate bowel function, colonic manometry to test how well the large intestines operates and esophageal manometry to study how efficiently food is propelled to the stomach. Antroduodenal manometry tests how well the stomach and intestines contract to move food through the bowel.
Only children's hospitals in Jackson, Atlanta, Dallas and Houston offer this level of testing in the southern United States.
Having biofeedback therapy here in Mississippi is a help to Songe Ulmer of Hattiesburg, who had been taking her daughter to Atlanta for treatment before being referred to UMMC. Mercedez, 9, suffered from a bacterial infection that prompted problems in her gastrointestinal tract.
“It's better being closer to home,” she said.
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