Does my child need to see a pediatric gastrointestinal specialist?
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. Specialized training and experience in pediatric gastroenterology are important.
Pediatric gastroenterologists treat children from the newborn period through the teen years.
Simon S Rabinowitz, PhD, MD, FAAP
Professor of Clinical Pediatrics
Vice Chairman, Clinical Practice Development
Pediatric Gastroenterology, Hepatology, and Nutrition
SUNY Downstate College of Medicine
The Children’s Hospital at Downstate
Voice: 718 270-1647
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:
- Bleeding from the gastrointestinal tract
- Lactose intolerance
- Food allergies or intolerances
- Severe or complicated gastroesophageal reflux disease (reflux or GERD)
- Inflammatory bowel disease
- Short bowel syndrome
- Liver disease
- Acute or chronic abdominal pain
- Chronic constipation
- Chronic or severe diarrhea
- Pancreatic insufficiency (including cystic fibrosis) and pancreatitis
- Nutritional problems (including malnutrition, failure to thrive, and obesity)
- Feeding disorders
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.
Celiac Disease – What to look out for…
Gluten is a protein found in wheat, rye, and barley — grains that are in many everyday foods. Most of us eat food with gluten with no trouble. But for some people, eating gluten can cause a reaction in their bodies. Someone who has this problem has celiac disease.
For someone with celiac disease, eating gluten — in a piece of bread, for instance — causes an immune system reaction. Your immune system ordinarily keeps you from getting sick, but in someone with celiac disease, the body starts damaging and destroying the lining of the intestines. Without the microscopic villi, which are finger-like projections, the body can’t absorb vitamins and nutrients from food. Without enough nutrients, a child’s body cannot stay healthy and grow properly. Even if the child eats a lot, he or she might still lose weight and might develop anemia from not absorbing enough iron. About 1 in every 133 people in the United States has celiac disease.
Obviously, many people who have celiac disease do not know it. If all these people were diagnosed, celiac disease would be more common than type 1 diabetes. Fortunately, awareness is growing about the problem, and there are better ways of testing people for it.
Signs and Symptoms: If your child has many stomachaches, diarrhea, weight loss, bloating, or poor growth. Someone with celiac disease may feel tired and could be irritable. Some also have skin rashes and mouth sores. The problem is sometimes mistaken for other digestive problems called inflammatory bowel disease or lactose intolerance. And in some cases, a kid won’t have any symptoms and then will all of a sudden start having problems during a time of stress, such as after an injury.
If your child has any of these signs and symptoms it may or may not be celiac disease, but a pediatric gastroenterologist can help sort this out and will usually order a screening blood test. Many kids are diagnosed with it when they’re between 6 months and 2 years old. It makes sense, because at this time kids are getting their first taste of gluten in foods.
For some people, the problems occur gradually and the symptoms may be terrible one week and not as bad the next. Because of this, some people aren’t diagnosed with celiac disease until they’re older. The problem is chronic, which means that although symptoms may come and go, people who have celiac disease will always have it.
Dr. Simon Rabinowitz, Pediatric Gastro-enterologist