Sarah Boushey-George, R.N., M.S.,PNP—As the pediatric nurse practitioner forthe Pediatric Gastroenterology & NutritionProgram, Sarah sees both new and continuingpatients in our gastroenterology and feeding

clinic. She received her R.N., M.S. and PNP degrees fromthe University of California, San Francisco.

Vance Coleman, R.N.—Vance is the nurseclinician for the Pediatric Gastroenterology &Nutrition Program. In this role, he providespatient education, triages phone calls for ourmedical providers and assists patients and

families in preparing for procedures and hospitalizations.He received his B.S. in Nursing from SouthwesternOklahoma State University.

Ruby Ng, M.D. MPT, MSc, BCIAC—Dr. Ng is a clinical rehabilitation specialist whohas provided care for children at CaliforniaPacific’s Pediatric Clinic since 1992. Shereceived her M.D. from Ross University and a

Masters in Physical Therapy from Chapman University.She is certified in pelvic muscle dysfunction, is a fellow ofthe Biofeedback Certification Institute of America(BCIAC) and a board member of the Biofeedback Societyof California (BSC).

Lonnie Wong, R.D., CNSD—Lonnie is apediatric dietitian at California Pacific MedicalCenter. She assesses patients’ nutritional needsand provides diet education for both hospitalized patients and outpatients. She

received her B.S. in dietetics from University of Californiaat Berkeley and completed a dietetic internship atUniversity of Oregon Medical Center and Health Sciences.

Our TeamOur Pediatric Gastroenterology & Nutrition Teamprovides multisciplinary care, meaning that we havea team of specialists who work together to care foreach child’s needs. These specialists include doctors,nurses, social workers, a psychologist, nutritionist,physical and occupational therapists, and child lifeand art therapists.

J. Antonio Quiros, M.D.—Dr. Quiros ismedical director of California Pacific’s PediatricGastroenterology & Nutrition Program. He pre-viously practiced at the University of CaliforniaDavis Medical Center and was an Advanced

Fellow in Therapeutic Endoscopy at Stanford UniversityMedical Center. He did his sub-specialty training inPediatric Gastroenterology at the Children’s Hospital LosAngeles and completed his residency in Pediatrics andInternational Health at Case Western Reserve UniversitySchool of Medicine in Cleveland, Ohio. Dr. Quiros is amember of the Physician Foundation at California PacificMedical Center

Christine Nguyen, M.D.—Dr. Nguyenjoined our Pediatric Gastroenterology &Nutrition Program following completion of afellowship in Pediatric Gastroenterology,Hepatology and Nutrition at Lucille Packard

Children’s Hospital, Stanford University Medical Center.She earned her M.D. from the University of TexasSouthwestern Medical School in Dallas and completed herpediatric residency at Georgetown University MedicalCenter. Dr. Nguyen is a member of the PhysicianFoundation at California Pacific Medical Center.

Copyright © 2007 California Pacific Medical Center. All rights reserved.PEDS-gibro-2007

Printed on 100% recycled paper.

PediatricGastroenterology &Nutrition Program

Pediatric Gastroenterology & Nutrition ProgramWomen & Children’s CenterCalifornia Pacific Medical Center3700 California StreetSan Francisco, CA 94118www.cpmc.org/pediatrics

Physician Foundation atCalifornia Pacific Medical CenterPediatric Specialty Care Center3700 California Street, Suite B555San Francisco, CA 94118www.pfcpmc.org

Tel. 415-600-0770 (Appointment Scheduling)Toll Free 866-663-KIDS

Tel. 888-637-2762 (Physician Referral Line)

Care CentersThe Physician Foundation at California Pacific MedicalCenter offers pediatric gastroenterology care centers in thefollowing cities:

Marin 415-600-07701100 S. Eliseo Drive, Ste. 1 or 866-663-KIDSGreenbrae, CA 94904

Santa Rosa 415-600-0770990 Sonoma Ave., Bldg. 9 or 866-663-KIDSSanta Rosa, CA 95404

San Mateo 415-600-0770210 Baldwin Avenue or 866-663-KIDSSan Mateo, CA 94402

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department of pediatrics

Pediatric Gastroenterology & Nutrition

Appointment Scheduling 415-600-0770Toll Free 866-663-KIDS

Physician Referral Line 888-637-2762

J. Antonio Quiros, M.D. 415-600-0750Medical Director

Christine Nguyen, M.D. 415-600-0750

www.cpmc.org/pediatrics Beyond Medicine.

OverviewOur Approach At California Pacific Medical Center,our Pediatric Gastroenterology & Nutrition Teamspecializes in the diagnosis and management ofboth routine and complex digestive disorders. Wecouple this expertise with personalized care, work-ing closely with each patient, family and referringphysician to determine the best treatment plan.

Family-Centered Care Family-centered care is an inte-gral part of our program. With this approach, ourmedical team works in partnership with each childand his/her family to determine the best plan ofcare. We share timely, complete information withpatients and families so they can effectively partici-pate in care and decision-making. We encourageongoing communication with our team.

Clinical Research Our team is active in clinicalresearch, offering patients entry into relevant studies.We have active studies in inflammatory bowel disease, recurrent and chronic pancreatitis andmotility disorders of the upper gastrointestinal tract(gastroesophageal reflux, dysphagia, etc.).

What Happens at a Clinic Visit?During a clinic visit, one of our board-certified pediatric gastroenterologists and a pediatric nursespecializing in gastroenterology will complete athorough medical history and exam of your child.The gastroenterologist reviews previous studies and thoroughly examines all relevant body systems.Usually, a clinic visit lasts about one hour for newpatients.

To assist with the gastroenterology team’s assess-ment of your child, please bring any relevant med-ical records and test results.

For out-of-town patients, the Cathedral HillHotel is affiliated with California Pacific MedicalCenter and offers discounted rates to our patientsand families. A shuttle runs between the hotel andhospital.

Our Services Specialized ProceduresSometimes, additional procedures are required tohelp diagnose or treat a GI-related problem. Ifyour child requires such a procedure, our gas-troenterologists will explain the need for the test,its procedure and potential risks, and possibleoutcomes. Among the tests we perform include:

Anorectal Manometry: This test measurespressures in the rectum (last part of colon) andanus. It is indicated in chronic constipation orfecal incontenence, to evaluate injured nerves ormuscles, confirm suspected Hirschprung’s disease, or to evaluate appropriateness forbiofeedback.

Biofeedback: Biofeedback assists a child in managing health problems such as constipationand encopresis (fecal soiling) through muscleawareness and re-education. A computer, sensorsand games are used to identify physiologicalchanges in the body. No invasive probes are used.

Breath Hydrogen Testing: Hydrogen inexhaled breath is measured to evaluate for lactose intolerance, intolerance of other sugars, or bacterial overgrowth.

Endoscopic Ultrasound (EUS): This procedureinvolves using high-frequency ultrasound visual-ization from within the intestinal tract to look at intestinal and adjacent lesions that may beamenable for resection and biopsy using differentmodalities and techniques.

Endoscopy (Upper): A flexible tube is insertedinto the mouth to visualize the esophagus, stomach, and first part of small intestine. Upperendoscopy is indicated for evaluating vomiting,trouble swallowing, poor growth, diarrhea, stomach pain or foreign body impactions.

Our specialists provide multidisciplinary diagnosis,therapy and long-term care for children ranging inage from 0–18 who have nutritional, gastrointestinal,liver and pancreatic disorders.

We see children with the entire range of GI conditions including:

• Inflammatory bowel diseases (Crohn’s disease,ulcerative colitis)

• Malabsorptive disorders (celiac disease, chronicdiarrhea)

• Recurrent pancreatitis and hepatobiliary disease• Chronic hepatitis• Gastroesophageal reflux disease (GERD)• Peptic ulcer disease• Feeding dysfunction/failure to thrive• Functional bowel disorders (IBS, chronic

constipation)• Gastrointestinal manifestations of allergic disease

Additionally, our Feeding Disorders Clinic providescomprehensive assessment and treatment for youngchildren with feeding problems and oral-motor concerns.

Endoscopy (Lower) (also known ascolonoscopy): A flexible tube is advancedthrough the colon and into the last part of thesmall intestine. A colonoscopy is indicated toevaluate lower abdominal pain, blood in stool,iron deficiency anemia, bowel inflammation, or totest and/or treat some polyps or small lesions ofthe colon.

Esophageal Manometry: This test measures thepressures and motility in the esophagus. It isindicated for children with difficulty swallowing,chest pain, food impactions, or to evaluate ifmedicines or surgery for reflux are working.

Liver Biopsy: A liver biopsy provides a verysmall sample of liver tissue for diagnostic tests.The procedure is performed with sedation andinvolves insertion of a needle through the skinand into the liver to obtain a tissue sample.

Pancreaticobiliary Endoscopy: This procedureuses specialized endoscopic techniques for mini-mally invasive access into the pancreatic and biliary systems for therapeutic indications.

Contact UsContact our team for patientreferrals or questions. We have a 24-hour on-callpediatric gastroenterologistaccessible at the numbers listed on the back.