Children's Hospital Colorado

Gastroenterology and GI Surgery Research

Dr. Shikha Sundaram gives a high five to a teenage patient.
Research article

Shikha Sundaram, MD, a pediatric hepatologist at Children’s Hospital Colorado, is investigating how nocturnal hypoxia and sleep apnea may affect the liver in patients with non-alcoholic fatty liver disease (NAFLD).


Advancing care through research and innovation

As one of the nation’s leading pediatric gastroenterology, hepatology and nutrition programs, the faculty and staff at the Digestive Health Institute are committed to advancing knowledge and clinical care in order to improve the digestive health of our patients. Through basic, translational and clinical research, faculty members are identifying the mechanisms underlying disease, developing new diagnostic tests and testing novel therapeutic interventions and preventative strategies.


Inflammatory bowel diseases: Our participation in collaborative multi-center studies identified novel quality measurement tools and tested new therapeutic approaches, both using new drugs and novel nutritional approaches. Laboratory studies determined the key roles played by heat shock proteins on T regulatory cell function and new inflammatory pathways of the intestine.

Eosinophilic gastrointestinal diseases: Our research and development team has developed a novel, low cost, minimally invasive monitoring test for esophageal inflammation, the esophageal string test. We have also described a new mouse model of eosinophilic gastrointestinal disease that will be instrumental for understanding these diseases and testing new therapeutic approaches.

Celiac disease: Our ongoing unique population-based study of celiac disease has shown a much higher prevalence than previously described in the United States. Translational studies have identified novel blood tests for celiac disease and have described the pathogenetic relationships of celiac disease with diabetes. Studies of the effect of a gluten free diet on a variety of parameters are ongoing.

Endoscopic procedures: A key clinical study helped establish the national guidelines for treating children with button battery ingestions, and our researchers actively pursued the removal from market of the dangerous rare earth magnets that children can ingest with subsequent damage to their intestines.

Short bowel syndrome and intestinal rehabilitation: Clinical studies have helped establish national guidelines for clinical assessment and treatment approaches to children with intestinal failure. We continue to actively study the role of intravenous lipid modifications in the prevention and treatment of TPN associated liver disease.

Aerodigestive: The Aerodigestive Program helps care for children with complex airway and gastrointestinal diagnoses. In an attempt to provide better outcomes and more efficient and less costly care, the program has numerous research projects to evaluate the success and outcomes of treatments. Such projects currently include: evaluating the results and impacts our procedural testing has on our patients, evaluating the flow of the operating room for multidisciplinary procedures and developing new and safer endoscopic procedural techniques.


Childhood Liver Disease Research and Education Network (ChiLDREN): Our researchers provide the leadership and direction of this collaborative research network at 16 sites (funded by the National Institutes of Health) with the goal to gain a better understanding of the etiology and outcomes of eight rare pediatric liver diseases and to develop tools predictive of outcomes and to personalize and test new therapies.

The diseases include biliary atresia, Alagille syndrome, alpha-1 antitrypsin deficiency, familial cholestasis, bile acid defects, mitochondrial disorders and cystic fibrosis liver disease. ChiLDREN is chaired by Ronald Sokol, MD, and studies the largest cohorts in the world with these diseases. The team is currently investigating the genetic and environmental influences on these diseases and is performing multiple clinical trials.

Biliary atresia (BA) and Parenteral Nutrition-associated Liver Disease (PNALD): DHI investigators are using novel mouse models and basic laboratory research to discover clues to the causes of BA and PNALD and are designing and testing potential therapeutic approaches in these models. Basic research is also identifying genetic and epigenetic factors that are essential to the formation of bile by the developing liver and during illness.

Acute liver failure: Our team is leading national studies of the causes, treatment options and predictive modeling of this devastating condition.

Viral hepatitis: Our team plays a key role in multi-centered trials of new therapies for Hepatitis B and C viruses, which have led to improved eradication of these viruses in children. We have also developed national guidelines for evaluation and care of children infected with these viruses.

Non-alcoholic fatty liver disease (NAFLD): Our team is studying the cause of NAFLD, the most common liver disease in children and adults. Ongoing translational studies suggest that decreases in oxygen during sleep caused by obstructive sleep apnea, which is common in obese children, plays a role in the development and progression of pediatric NAFLD. Interventional studies are ongoing to test new therapies.

Liver transplantation and immune tolerance: Our participation in collaborative multi-centered studies has defined the factors that determine long term outcomes after pediatric liver transplantation. Ongoing clinical trials will help identify those children who develop tolerance to the transplanted liver and can be taken off of immunosuppressive therapy.

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