With the same transabdominal ultrasound technology used to monitor fetal development during pregnancy, Dr. Michael Dolinger slides a probe over the patient's belly to detect evidence of inflammation in the bowel wall, a measure of disease activity.
Credit: Mattheau O鈥橞rien
In March, Michael Dolinger, MD, MBA, joined Hassenfeld Children鈥檚 Hospital at 黑料福利社 Langone as director of the Pediatric Inflammatory Bowel Disease (IBD) Program. With advanced training in pediatric gastroenterology, he is an expert in diagnosing and treating children with IBD, a group of chronic conditions that include Crohn鈥檚 disease and ulcerative colitis and that affect 100,000 Americans under age 20. These diseases cause the intestines to become inflamed and ulcerated, compromising the ability to process food and waste or to absorb protein.
Dr. Dolinger is nationally recognized for his pioneering use of intestinal ultrasound (IUS) as a tool for assessing disease activity. He treats patients at 黑料福利社 Langone鈥檚 Fink Children鈥檚 Ambulatory Care Center and Inflammatory Bowel Disease Center. 鈥淚鈥檝e always been driven by the desire to make a real difference in the lives of children with IBD,鈥 Dr. Dolinger says. Here, he shares insights into his innovative approach.
I believe physicians who have a personal connection to their work tend to excel at caring for patients on a deeper level. My journey into medicine was profoundly influenced by my wife, Tess, who was diagnosed with Crohn鈥檚 disease at age 6. Now that my training has enabled me to fully grasp the complexity of the disease, I realize that Tess has among the most severe cases. Despite being treated by top specialists and having undergone dozens of surgeries, she continues to face significant challenges. Witnessing her daily struggles ignited my determination to enhance care for patients with IBD, moving beyond conventional treatments and management strategies to improve their quality of life.
I chose to specialize in pediatric gastroenterology because these diseases can severely impact the lives of young patients and their families. Children with IBD face many challenges, including disruptions in growth and puberty, nutrition, mental health, school attendance, and overall quality of life. Complicating matters is the fact that medicines work for only about 30 percent of patients, and we often must wait a year to find out that they鈥檙e not working.
Early in my career, I met one child after another who had undergone seemingly endless invasive procedures for their IBD, yet resulting in little or no improvement. Recognizing the limitations of traditional diagnostic and monitoring methods, I strove to do better. After training in Denmark, Germany, and Italy, I became the first gastroenterologist in the United States to be certified in performing intestinal ultrasound during routine office visits. This noninvasive technique makes it possible to obtain precise, real-time information about a patient鈥檚 response to treatment and progress in healing. Now, with close IUS-based monitoring strategies, we can detect treatment response or nonresponse earlier, potentially leading to earlier treatment decisions and improved outcomes.
IUS is a traditional transabdominal ultrasound, commonly used during pregnancy to monitor fetal development. We slide a probe over the patient鈥檚 belly systematically to detect signs of inflammation in the bowel wall. Because the test is safe and convenient, we can perform it as often as needed. For young children, IUS is particularly valuable. It avoids the oral and intravenous contrast or sedation they often require for magnetic resonance enterography, a type of MRI that provides detailed images of the small intestine, as well as radiation exposure from repeated CT scans. Moreover, the test requires no fasting, vein puncture, or contrast agent. I often have results within 10 minutes.
To extend the benefits of this tool, I cofounded the Intestinal Ultrasound Group of the United States and Canada. We lead educational initiatives, training hundreds of clinicians across North America to become proficient with intestinal ultrasound. By teaching more clinicians how to use it, we aim to elevate the standard of care for IBD patients on a broader scale. Put simply, in my opinion, IUS is the biggest innovation in the field of gastroenterology since colonoscopy. It will completely change the landscape of IBD management. As the technology advances, patients may one day be able to use a handheld IUS device or even an ultrasound patch to monitor themselves at home.
At the Inflammatory Bowel Disease Center, we recognize that each patient鈥檚 experience with IBD is unique, so we collaborate closely with patients and their families to individualize treatment plans. The center takes a holistic approach, integrating the latest therapies with nutritional guidance, emotional support, and shared decision-making. It鈥檚 important to explain to children what鈥檚 going on, especially during their teenage years. Doing so gives them a sense of ownership and validation for what they鈥檙e experiencing and makes them feel like someone understands what they鈥檙e going through. And as they grow into young adults, we help them transition seamlessly from a pediatric to an adult setting, ensuring continuity of care.
My colleague Dr. Simon J. Hong uses IUS for adult patients at the Inflammatory Bowel Disease Center. We are privileged to offer this diagnostic tool at a leading institution like 黑料福利社 Langone, which is ranked among the top five hospitals in the nation for gastroenterology and gastrointestinal surgery by U.S. News & World Report, and we look forward to introducing it to more of our colleagues.
