WHAT IS PEDIATRIC GASTROENTEROLOGY?

When children have a digestive system, liver, or nutritional problem, those who have the expertise to treat your child would be a pediatric gastroenterologist. The problems in children are often quite different from those experienced by adults, so therefore specialized training and experience in the field of pediatric gastroenterologists are important for your child's health and nourishment. The treatment provided by pediatric gastroenterologists span from newborn infants through to 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.

WHY SHOULD CHILDREN SEE A PEDIATRIC GASTROENTEROLOGIST?

When it comes to children diagnosing and treating problems are most effective and recommended when it is still in the early stage of the issue, the following are the general treatments pediatric gastroenterologists provide:

• Acute or chronic abdominal pain
• Bleeding from the gastrointestinal tract
• Chronic constipation
• Chronic or severe diarrhea
• Feeding disorders
• Food allergies or intolerances
• Inflammatory bowel disease
• Lactose intolerances
• Liver disease
• Nutritional problems (including malnutrition, failure to thrive, and obesity)
• Pancreatic insufficiency (including cystic fibrosis) and pancreatitis
• Severe or complicated gastroesophageal reflux disease (reflux or GERD)
• Short bowel syndrome
• Vomiting

WHAT PROCEDURES ARE PERFORMED BY GASTROENTEROLOGISTS?

There is a wide range of nonsurgical procedures that gastroenterologists can perform, which include:

• Capsule endoscopies to examine the small intestine
• Colonoscopies to detect colon cancer or colon polyps
• Double balloon enteroscopies to examine the small intestine
• Endoscopic retrograde cholangiopancreatography to identify gallstones, tumors, or scar tissue in the bile duct area
• Endoscopic ultrasounds to examine the upper and lower GI tract, as well as other internal organs
• Liver biopsies to assess inflammation and fibrosis
• Sigmoidoscopies to evaluate blood loss or pain in the bowel

WHEN SHOULD YOU TAKE YOUR CHILD TO A PEDIATRIC GASTROENTEROLOGIST?

Particular digestive issues that occur in children usually pass quickly and are often mild, there are no excessive symptoms or reactions however, it does not mean that children don't encounter issues. If children start exhibiting certain behaviors or signs of problems you must act quickly and call a physician immediately.

Here are some common identifiers:

1. Vomiting
   • When children regurgitate they do so under many different reasons, such as when they get a viral infection, motion sickness, food poisoning, eating too much, fever, they cough too much, become over-excited, nervous or worried. When they are sick with serious diseases such as meningitis, appendicitis, and intestinal blockages this can also cause them to vomit. Along with vomiting, kids may also have diarrhea, stomach pain or fever.
   • When to contact your physician:
     • You must contact your pediatrician if your child has vomited more than once, there is blood or bile in the vomit, or if your child is under the age of 6 and is having difficulty keeping liquids down. For older children, if they have vomited more than twice in a 24-hour period, or the vomit has blood or bile, call your physician. You should also call your doctor if there is associated fever, diarrhea, or signs of dehydration, which includes:
       • Decreased urination
       • Dry lips
       • Decreased energy
       • Your child looks unwell to you
2. Abdominal pain
   • Pain is the signal the body sends to the brain when there is a serious problem. There may be mild issues happening within the body already, but if it goes as far as sending a pain signal then there is definitely a serious issue. At times when a single pain signal occurs there may not be only one issue involved but multiples unknown issues. When this occurs in children it can be sure that it may become serious if not treated with haste.
   • Some of these issues are:
     • Constipation
     • Diarrhea
     • Food poisoning
     • Gastroentiritis (stomach flu)
     • Gastritis (inflammation of the lining of the stomach)
     • Overeating
   • There are many other issues that can cause abdominal pain, which may also be accompanied by bloating, cramping, nausea, or general discomfort. Some less common causes of abdominal pain include:
     • Food allergies
     • Irritable bowel syndrome
     • Appendicitis
     • Intestinal obstruction
     • Pneumonia
   • When to contact your physician:
     • If your child is undergoing through severe pain, or a pain going on for more than two weeks, it would be advised that you talk to your pediatrician or bring your child to the hospital in extreme circumstances.
3. Constipation and Diarrhea
   • There are all kinds of things that can cause constipation in your kids, such as, potty training stress, a low-fiber diet, poor bowel habits, irritable bowel syndrome, diabetes, medications, lack of fluids or exercise.
   • Symptoms of constipation include:
     • Abdominal pain
     • Stomach cramps
     • Painful bowel movements
     • Fewer than normal bowel movements
   • When to contact your physician:
     • If you see blood in your child's stool, call your physician. If your child is not having at least one bowel movement every other, if movements are painful, if there is blood in the stool, or more than normal pushing is needed during a bowel movement then you'll want to contact your physician as soon as possible.
4. GERD (Gastroesophageal Reflux)
   • This is particularly common in children, especially very young kids. There are many things that can trigger the acidic backflow of reflux, including:
     • Food allergies
     • Problems with the lower esophageal sphincter (LES), a muscle at the bottom of the esophagus
   • When to contact your physician:
     • The good thing to note is that reflux tends to get better on its own, or can be prevented by avoiding trigger foods like chocolate and fatty foods.
     • The signs that GERD may be serious include:
       • Poor weight gain
       • Poor appetite
       • Vomiting green or yellow fluid
       • Stomach or chest pain
       • Breathing problems
       • Chronic cough
       • Crying or moodiness
       • Problems swallowing
5. Picky Eating
   • When children become picky eaters this is when parents should watch their children, the symptom can at times be vague it may be a sign of many digestive problems. GERD can cause children to be fussy eaters, because the smell or texture of a certain type of food can lead to picky behaviors, as can gastrointestinal infections and diarrhea.
   • If your child practices limited eating it is also a sign of eating disorder like anorexia or bulimia. This condition is more common teens and young adults, eating disorders however, can occur in children of any age, even as young as 5 years of age.
   • When to contact your physician:
     • If your child is experiencing poor weight gain, if they vomit or gag on certain foods, if they experience heartburn or GERD when they eat or have abdominal pain during or after meals then it would be advised to call your pediatrician.
6. Other digestive health problems in kids
   • There are other issues that can cause children to have digestive problems, however these issues are less common, such as:
     • Bowel obstruction
     • Celiac disease
     • Congenital bowel or liver issues
     • Crohn's disease
     • Hepatitis
     • Pancreatitis
     • Ulcerative colitis