Voice, Swallowing and Nutrition Center Services

The Voice, Swallowing and Nutrition Center (VSN) of AHN’s Esophageal Institute provides diagnostic evaluation and treatment for diseases of the pharynx, larynx, esophagus and stomach. Problems addressed by the center include difficulty swallowing, aspiration, chronic cough, GERD, hiatal hernia, Barrett’s Esophagus, achalasia, pharyngeal and esophageal diverticulum, linguistic deficits, weight management problems related to GI disorders, and other complaints.

Each discipline within the VSN provides independent as well as integrated care depending on the needs of the individual patient. The VSN is run in collaboration with the ELI clinic at West Penn Hospital. Through active bilateral communication among providers, new patients we need evaluation are often seen during the same day by both the VSN and ELI clinics. This multidisciplinary approach enables our team to provide the best, most comprehensive care for our patients.

In addition to identifying and testing new diagnoses, the VSN provides a spectrum of assessment and treatment, including support during all phases of surgery. We also provide behavioral management of voice and swallowing disorders. Appointments can be booked directly or in follow-up to other treatment. 

Available services

The Swallowing Center offers independent services in the areas of speech pathology, nutritional services, and esophageal/gastric physiology testing.

Speech Pathology

The Swallowing Center can provide services for the patient who is experiencing:

•  Dysphagia

• Vocal dysfunction

• Dysarthria

• Aphasia

• Cognitive – Linguistic Deficits

Instrumental evaluation of swallowing can be performed onsite by our speech pathologist who is certified and trained in F.E.E.S (Fiberoptic Endoscopic Evaluation of Swallowing) and experienced in comprehensive swallowing evaluations. Once evaluated, a plan of care will be developed according to the deficits, address insurance requirements, and initiate treatment.

Speech therapy for dysphagia may include:

• Oral and pharyngeal strengthening and range of motion exercises

• Compensatory techniques

• Diet modification

The speech–language pathologist will work closely with the Institute’s registered dietitian to utilize an interdisciplinary approach to patient care.

Comprehensive evaluations and treatment for disorders of communication, language and cognition will be performed and implemented on a case by case basis.

Speech and Language Pathologist services provided at West Penn Hospital. 

Nutrition services

Our Dietitians offer comprehensive nutritional assessments with the goals of improving patients’ nutritional status, improving quality of life through nutrition adequacy, and strengthening and improving patients’ tolerance for other interventions.

Our interventions include:

• Evaluation of GI symptoms such as nausea, vomiting, bloating, constipation/diarrhea.

• Diet direction and lifestyle modification for patients with Gastroesophageal Reflux Disease

• Dietary review for foods that are known GI irritants, which can trigger symptoms

• Lifestyle modification and functional nutrition intervention to help manage better comfort and less symptom-driven distress

Counseling and preparation for dietary adequacy for patients undergoing surgical interventions the in Esophageal Institute. Pre- and Post-surgery, dietitians can assist in preparing adequacy, appropriate texture, and timely advancement of diet.

Assessment, nutrition planning, and treatment for other conditions with or without surgery, such as:

• Achalasia

• Barrett’s Esophagus

• Esophageal Diverticulum

• Gastroparesis

• Eosinophilic Esophagitis (EoE)

• Esophageal cancer

• Pyloroplasty

Gastric Emptying Studies for patients with Gastroparesis, or delayed gastric emptying.

Diagnostic testing services, including:

• SmartPill procedure and monitoring

• Evaluation for gastric pacemaker

• Dilation of or Botox to the Pylorus

• Food elimination studies

• Texture tolerance baselines

Weight management, including weight loss and weight gain.

Dietitian services are available at West Penn Hospital and Peters Township Health + Wellness Pavilion.

Esophageal Physiology Testing

The Voice, Swallowing, and Nutrition Center evaluates esophageal and gastric function by utilizing state-of-the-art equipment. Patients with the following issues would be ideal candidates for this type of testing: dysphagia, food-sticking sensation, reflux, heartburn, unexplained cough, etc.

The following tests are available:

• High-resolution esophageal motility with impedance study - Manometry

• 24 hour pH Impedance testing

• BRAVO (48 hour) pH monitoring system

• SmartPill®

• PillCam®

• Endoscopic Ultrasound

• Upper Endoscopy

The studies are analyzed by one of our physicians and a report is generated and sent to the referring doctor. Esophageal testing is available at West Penn Hospital and Peters Township Health + Wellness Pavilion.

Our providers

The Voice, Swallowing and Nutrition Center is staffed by a multidisciplinary team that works in conjunction with the Esophageal Institute to provide care for the whole person. VSN staff include:

Brittany Weber, MD

Brittany Weber, MD, is an otolaryngologist who provides patients of all ages with diagnosis and medical and surgical treatment of illnesses and disorders of the ears, nose, and throat. She has special clinical interest in voice disorders.

Kimberly Fleming, PhD

Kimberly Fleming, PhD, is a clinical health psychologist specializing in providing comprehensive treatment to patients with chronic medical conditions, including gastrointestinal problems. Dr. Fleming’s collaborative approach tailors individual treatment plans to decrease frequency and intensity of depression and anxiety symptoms, improve quality of life, decrease distress from medical symptoms, effectively manage stress, and improve coping skills. Her approach is rooted in evidence-based psychological practices, including cognitive behavioral therapy and mindfulness-based therapies (e.g., Acceptance and Commitment Therapy, Dialectical Behavior Therapy). As part of the multidisciplinary ELI team, Dr. Fleming works collaboratively with the entire ELI team to ensure that individuals’ are receiving the best possible care.

Leah Nestlerode, MA CCC-SLP

Leah Nestlerode, MA CCC-SLP, is a state-licensed and certified speech language pathologist. She received her bachelor’s degree from The Pennsylvania State University in Speech Pathology in 2012, and her Masters’ degree from the University of Pittsburgh in Speech Pathology in 2014. Her clinical focus is medical speech language pathology, receiving her clinical fellowship training at the VA Hospital in Pittsburgh. She specializes currently in the assessment and treatment of dysphagia and voice disorders.

Ann DeWitt, RD

Ann DeWitt, RD, is a Registered, Licensed Dietitian with the American Dietetic Association since 1997, a member of the ADA, and diagnostic practice groups of Oncology Nutrition and Functional Nutrition, with recent Food Allergy and Integrative and Functional Nutrition Certifications. Her role is to provide nutrition services that optimize outcomes of surgical interventions through pre- and post-operative diet texture and adequacy education; weight management, gastrointestinal symptoms management, disease specific diet education, resource planning and providing alternate nutrition solutions. Ann also works closely with esophageal cancer patients to provide nutrition interventions that contribute to improved outcomes. She strives to improve continuity of care through relationships within the community including home health, rehab/skilled facilities, physician’s offices, and within the field of dietetics.

Rachel McGurk, RD, CGS, LDN

Rachel McGurk, RD, CGS, LDN completed her Bachelor of Science in Clinical Nutrition and Dietetics from the School of Health and Rehabilitation Sciences at the University of Pittsburgh. She has extensive experience working with an adult and geriatric clientele and is a Board Certified Specialist in Gerontological Nutrition. Rachel currently focuses primarily on conditions that affect the esophagus, stomach and intestinal tract.

Contact us

Call (412) 359-GERD (412) 359-4373 in Pittsburgh or (844) 412-GERD (844) 412-4373 in Erie for more information or to book a consultation.