Patient Resources

What is a Pediatric Gastroenterologist?

If your child has a digestive system, liver, or nutritional problem, a pediatric gastroenterologist has the expertise to treat your child. Digestive, liver, and nutritional problems in children often are quite different from those seen in adults. Pediatric gastroenterologists treat children from the newborn period through the teen years. They choose to make pediatric care the core of their medical practice, which provides extensive experience specifically in the care of infants, children, and teens. Children are not just small adults. Their bodies are growing and have unique medical needs. They usually express their concerns differently than adults. They cannot always answer medical questions and are not always able to be patient and cooperative. Pediatric gastroenterologists know how to examine and treat children in a way that makes them relaxed and cooperative. Pediatric gastroenterologists focus on problems unique to pediatric patients, including growth, maturation, physical and emotional development, and age-related social issues.

What kind of training do Pediatric Gastroenterologists have?

Pediatric gastroenterologists are medical doctors who have had at least 4 years of medical school three years of pediatric residency training. Three years of additional training in pediatric gastroenterology, hepatology, and nutrition, including medical research and treatment of infants, children, and teens with digestive, liver, and nutritional disorders Certification in pediatrics from the American Board of Pediatrics, and in gastroenterology and nutrition from the American Board of Pediatrics Sub-board in Pediatric Gastroenterology.

What Types of Treatments Do Pediatric Gastroenterologists Provide?

Pediatric gastroenterologists generally provide treatment for the following:

Pediatric gastroenterologists are specially trained to perform diagnostic tests of a child’s digestive system. Special instruments, such as endoscopes, are used to examine the inside of the digestive tract or obtain tissue samples (biopsies). Endoscopic procedures pediatric gastroenterologists perform include esophagogastroduodenoscopy and colonoscopy. Pediatric gastroenterologists also treat bleeding, swallowing problems, or other problems encountered in the intestines. They have extensive expertise in managing nutritional problems in children, including placement and management of feeding tubes and intravenous nutrition and diagnosing and treating infants, children, and teens with liver disease.

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Brief Descriptions of Procedures:

A flexible tube with a camera is used to look into the last part of the intestines (colon and terminal ileum).  The test helps to evaluate polyps, inflammatory bowel disease, and other causes of gastrointestinal bleeding.  Small tissue samples, the size of a pinhead, are taken.  Polyps, which are growths of tissue lining the intestines, may also be removed.  The test is done with general anesthesia, usually as an outpatient.

Upper Endoscopy

This is the most common procedure.  A thin flexible tube with a camera is inserted in the mouth to see the esophagus, stomach, and first part of the small intestine.  The test is used to evaluate for acid reflux, ulcers, eosinophilic esophagitis, celiac disease, poor growth, and inflammatory bowel disease.  Small pieces of tissue, about the size of a pinhead, are usually taken for testing.  This test is done with general anesthesia, usually as an outpatient.

Esophageal pH Probe

This is a 24-hour test to measure the frequency that acid in the stomach goes up into the esophagus.  It is used to determine the effectiveness of antacids, to determine severity of gastroesophageal reflux, and to find out if certain symptoms such as cough, choking, or hoarse voice are related to gastroesophageal reflux.  Most patients may complete the test at home after the probe is placed.  They return the next day to have the probe removed.

Esophageal Motility Study (esophageal manometry)

This test measures if the esophagus muscle has normal pressures at rest and during swallowing.  It is indicated for children with difficulty swallowing, chest pain, or to determine if certain medicines or surgeries are working.

Anorectal Motility Study (anorectal manometry)

This tests measures pressures in the rectum (last part of the colon) and anus.  It can help find reasons for chronic constipation or fecal soiling, to evaluate injured nerves or muscles, and confirm suspected Hirschprung’s disease

Percutaneous Endoscopic Gastrostomy (PEG)

Children who cannot take enough calories by mouth or who have special nutritional needs may require a feeding tube.  A PEG is one way to place afeeding tube from the skin into the stomach.