Pediatric gastroenterologist makes waves with bowel ultrasound

When patients enter the doors of the Edmonton Pediatric Inflammatory Bowel Disease Clinic (EPIC), they receive holistic care that includes a team of a physician, a nurse, and a dietitian. The clinic offers bowel ultrasound to assess and monitor patients, potentially eliminating the use of an invasive colonoscopy. Hien Huynh envisioned these needs in pediatric gastroenterology and strived to bring them to reality.

The Department of Pediatrics recognized Huynh, the divisional director of Pediatric Gastroenterology and Nutrition, for his foresight with an innovation award. He saw how other countries use bowel ultrasound to monitor their IBD patients and reduce the need for more frequent repeated colonoscopies. Huynh then decided to be the first Canadian pediatric gastroenterologist to take the training. “Ultrasound has been around for a long time and people have been using ultrasound for a while, especially in Europe. But in North America, it’s not something that is commonly done,” he says.

He became interested in inflammatory bowel disease (IBD) because it is a lifelong condition and the disease has a big spectrum. Some patients can have mild symptoms and need very little support while others are on many medications and have side effects. “If we can find the right key to unlock this, potentially there could be a cure. I love that. We're making progress in treating the person,” says Huynh.

Huynh created EPIC so he could centralize treatment, track the successes, and measure the outcomes. About 50 to 60 pediatric patients are diagnosed per year and they are exposed to research projects, clinical trials, and novel treatments. The bowel ultrasound is key to determining if the novel treatments are having an impact. “An advantage for ultrasound is it is non-invasive. It doesn't need any prep at all. You can do it any time and do as many times as needed. You can see the bowel very well and get a fantastic resolution of the images,” he says.

With support from the Stollery Children’s Hospital Foundation, EPIC was the first pediatric clinic in Canada to have its own bowel ultrasound equipment. In addition, patients can influence the future care of others if they decide to take part in one of EPIC’s studies. The clinic is recruiting 50 to 60 patients for a bowel ultrasound study where they are scanned, then put on a medication, and scanned again to determine the effects of the medication over a period of a year. The ultrasound can show how thick the bowel is and how blood is flowing in that area. Physicians can often view a narrowing in the bowel where an obstruction is. The study will rule how well the ultrasound performs for a patient over time.

Huynh has already noticed that using the ultrasound strengthens patient engagement. “When the patients see the blockage, they become more responsive to change their treatment because it increases their education about their health. You have a very solid outcome measure covering the patient's symptoms,” says Huynh.

Edmonton and Calgary are the only two sites in the country to offer training for pediatric gastroenterologists in bowel ultrasound. But COVID-19 has stalled physicians from travelling to Edmonton to receive training from Huynh. He’s hoping his innovation award will increase awareness about this technology. “Too many people think it’s overwhelming to learn. Doing scopes requires a spatial skill as well. So it’s really not that far of a stretch,” he says.