Digestive Health Clinical Nutrition Program

At Loyola we have assembled a team of specially trained gastroenterologists, dietitians, nurses, surgeons and pathologists aimed at diagnosing and treating complex disorders of nutrition commonly resulting in malnutrition and weight loss. Our aim is to restore imbalances in digestion and absorption focusing on improving the health and lives of impacted patients.

Loyola has staff dietitians in several of the outpatient multidisciplinary clinics, and patients wishing to consult with a dietitian can be seen at various Loyola locations.

Additionally, patients with complex problems such as abnormal weight loss, malnutrition/malabsorption or short bowel syndrome, need for long term intravenous nutrition (“parenteral nutrition”) or feeding tubes (G-tubes) may be required and are managed by physicians and dietitians working together in a specialized nutrition support clinic.

Our nutrition support pharmacists have decades of expertise managing complex intravenous feeding and supplementation. Our physicians have advanced training in nutrition support and are nationally recognized for their expertise. 

Adult Clinical Nutrition Providers

What Conditions are Treated by the Clinical Nutrition Program?

The clinical nutrition specialists at Loyola Medicine are experts at diagnosing and managing patients with the following conditions:

• Abnormal weight loss
• Celiac disease and gluten sensitivity
• Cystic fibrosis
• Chylous (“fatty”) ascites (excess fluid in the abdomen)
• Food allergies or intolerances
• Gastrointestinal fistulas
• Intestinal malabsorption
• Iron deficiency (anemia) or any other vitamin deficiency
• Irritable bowel syndrome with a focus on dietary options
• Malnutrition, malabsorption and severe diarrhea
• Pancreatic insufficiency
• Patients with feeding tubes (gastrostomy, “PEG”) or who need feeding tubes inserted for nutrition
• Protein losing enteropathy
• Short bowel syndrome
• Small intestinal bacterial overgrowth
• Wasting from cancer, heart disease, cirrhosis, HIV or other chronic diseases 

Diagnostic Services Offered in the Clinical Nutrition Program

The Clinical Nutrition Program uses a variety of testing to help diagnose and manage nutrition-related diseases. As part of the evaluation of nutrition conditions, patients undergo one or several of the following tests:

Indirect Calorimetry: Patients who are losing weight for unknown reasons may have a problem with metabolism and may need more calories than expected. Loyola has the ability to measure the body’s daily calorie needs and metabolism through specialized breath testing to help your doctor determine how many calories you need to eat to maintain, gain or lose weight.  

Hydrogen breath testing for lactose and fructose intolerance: Breath testing for food intolerances involves administering a small dose of oral lactose and fructose and then blowing into a balloon collection container every 15 to 20 minutes for several hours to determine if your body can digest lactose and fructose.  

Small intestine bacterial overgrowth testing by hydrogen breath test and/or small intestine fluid sampling: Patients with gas, bloating, diarrhea or weight loss may have too many bacteria in their small intestine, causing malabsorption. In a similar process to lactose and fructose intolerance testing, we give a small dose of a liquid medication and have patients blow into a balloon collection container every 15 to 20 minutes for up to 4 hours to determine whether excess bacteria exists in the small intestine. 

Gastrointestinal motility testing: Some people have poor nutrition due to malfunctioning of gastrointestinal motility. Loyola offers the full range of intestine functioning tests, including tests to determine the stomach’s ability to empty (gastric emptying scans), tests of the function of the esophagus, stomach and upper small intestine (esophageal and antroduodenal manometry). 

Other tests for malabsorption: Loyola’s clinical nutrition specialists perform a wide array of tests to determine the cause and amount of intestinal malabsorption. This includes stool tests, blood tests for vitamin and mineral deficiencies, gastrointestinal endoscopy and biopsies, video capsule endoscopy (i.e.: pill camera) and small bowel enteroscopy where doctors can use specialized endoscopy equipment to examine and take samples from deeper portions of the small intestine not in the reach of a standard upper endoscopy. 

Clinical Nutrition Treatments at Loyola

Loyola’s clinical nutrition specialists have advanced training in all levels of nutrition support and offer comprehensive management of nutrition-related diseases using a multidisciplinary approach.

At Loyola, all members of the Clinical Nutrition Program are available to help patients and their families return to a healthy diet that supports healing.

Loyola’s clinical nutrition specialists are experts in:

• Comprehensive nutrition evaluation and assessment: People with nutrition-related disorders have consultations with our experienced registered dietitians and physicians to assess their current diets, degree of malnutrition, and to provide a patient-centered feeding plan to support health and healing.  
• Placement and management of intestinal feeding tubes: Many people have diseases that prevent them from eating normally, and often those people need to have devices inserted into their nose, stomach or intestines to provide feedings. Most of these devices are called “feeding tubes” and are usually made of medical-grade plastics or silicone. Loyola’s clinical nutrition specialists are experts at placing these devices and managing problems that can occur when using them.
• Management of parenteral nutrition: Patients who have non-functioning intestines or who have had large portions of their intestines removed often need intravenous feeding through a catheter inserted into a large vein in the arm or chest. Our nutrition support pharmacists and clinical nutrition specialists have extensive experience managing patients on parenteral nutrition and are well trained to minimize the discomfort and complications associated with intravenous feeding.  
• Dietary counseling for patients on special diets: Loyola’s registered dietitians have advanced training in medical nutrition therapy, including educating people with certain medical diseases like celiac disease, pancreatic insufficiency, food allergies and irritable bowel syndrome about the types of diets that can help them improve the symptoms of their disease.  
• Intestinal rehabilitation: Patients with intestinal failure and short gut syndrome need intensive medical therapy and dietary counseling to manage their nutrition and symptoms through a detailed and often difficult-to-follow diet. Loyola’s clinical nutrition specialists have helped many patients manage this difficult disease and bring some control back to their life.  
• Medical therapy of poor appetite due to chronic illness: Many people who suffer from chronic illnesses lack an appetite or desire to eat. Loyola’s clinical nutrition specialists are familiar with techniques and medications that can help improve nutrition for patients who are struggling.  
• Treatment of vitamin deficiencies: While many vitamin deficiencies can be treated with pills or oral supplements, some require intravenous infusions, and all require monitoring to avoid side effects and complications. Loyola has several forms of intravenous iron and other vitamins, and our clinical nutrition specialists routinely monitor for vitamin deficiencies.  
• Nutrition support during transplantation and cancer therapy: Organ transplantation and cancer therapies cause severe strain on our systems, and good nutrition is vital to improving outcomes from therapy. Loyola’s registered dietitians have advanced training in transplantation and cancer nutrition support, working with patients throughout the care process to ensure the best path to wellness. 

Ongoing Research

Loyola’s clinical nutrition specialists are actively engaged in patient-centered research that focuses on improving the outcomes of medical care through nutrition support and diet.

Loyola’s Clinical Nutrition team has extensive experience in clinical care and clinical research. Advancements and active research include:

• Development of international guidelines on the management of short bowel syndrome
• Improving the safety of delivery of parenteral nutrition
• Safety of feeding tube placement
• Studies on parenteral nutrition formulas and additives
• Reducing complications of liver disease from parenteral nutrition
• Optimizing quality of life in short bowel syndrome
• Use of novel hormones aimed at improving digestion and absorption in short bowel syndrome

Our specialists are routinely invited to speak at national meetings and serve on guideline committees that develop standards of care for patients with nutrition-related diseases. We also support patients enrolled in clinical trials within the Loyola system.

Our program continues to maintain an active research presence with participation in clinical trials, treatment registries, as well as patient opportunities to be part of a research database to ultimately help improve patient outcomes measured by not only treatment success, but also by high quality, efficient care delivery and patient satisfaction.

Learn about Loyola’s current clinical trials