Pediatric gastroenterologists are physicians who specialize in caring for babies, kids, and teens with diseases of the gastrointestinal (GI) tract and liver. The GI tract includes the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, and bile ducts.

Our approach to pediatric digestive care

Digestive problems are some of the most difficult to diagnose because many disorders and diseases can cause the same symptoms. Babies can’t tell us what they’re feeling and younger kids may also struggle to explain.

Our care starts by listening to you and your child. We know digestive issues can get in the way of their life and health. We provide care focused on each child to help them grow and thrive.

We care for a range of pediatric digestive disorders and nutritional problems in babies, kids, and teens. This includes:

Biliary disorders

We treat problems in the bile duct and tract. These can lead to liver failure if left untreated. Most childhood biliary disorders are present at birth. They cause jaundice or yellowing of the skin in newborns and babies. 

GI motility disorders

Motility disorders happen when the nerves and muscle of the GI tract don't work together to move food and liquid through. Childhood GI motility disorders we treat include:

• Achalasia: A motility disorder of the esophagus, or food tube. Your child’s esophagus doesn’t relax enough to let food enter the stomach. When this happens, they have difficulty swallowing liquids or solids. 
• Gastroparesis: When the stomach takes a long time to empty.
• Gastroesophageal reflux disease (GERD): GERD happens when stomach contents reflux, or back flow up the esophagus. Heartburn is a common symptom.
• Hirschsprung's disease: A rare condition someone is born with. They're missing nerve cells within the wall of their colon and rectum that control normal motion of food waste. Missing these cells means stool stops and gets stuck in the bowel. Most people are diagnosed as newborns.

Pediatric inflammatory bowel disease (IBD)

IBD happens when there’s ongoing and lifelong inflammation and irritation of the stomach, small intestine, and/or colon. The 2 types of IBD include:

• Pediatric Crohn’s disease: This can involve any area of the GI tract. The most common areas are the end and first part of the small intestine, the colon, and the stomach. 
• Pediatric ulcerative colitis: This involves only the colon, also called the large bowel.

GI allergic diseases

These are caused by reactions to certain substances, including food and environmental allergens. GI allergic diseases we treat include: 

• Celiac disease (CD): CD is a lifelong disease that happens in people allergic to eating gluten, a protein found in wheat, rye, barley, and related grains. It causes inflammation of the small intestine, making it difficult to absorb nutrients from food.
• Eosinophilic esophagitis (EoE): EoE is a lifelong disease that causes inflammation of the esophagus. It happens when someone has an allergic reaction to certain substances. Triggers can include specific foods and airborne allergens, such as from plants and trees. 
• Non-EoE eosinophilic gastrointestinal disease: Non-EoE involves inflammation in the stomach and intestines.
• Lactose intolerance: This is when your small intestine can’t break down lactose, a natural sugar found in milk and dairy products.

Other GI diseases and conditions

Our experts also treat:

• GI infections: Bacteria, viruses, or parasites can cause short-term digestive infections, also called stomach bugs.
• Pancreatitis: Inflammation of the pancreas. Some children may have lifelong or chronic pancreatitis. Their pancreas may lack the enzymes needed to break down food.
• Malabsorption syndromes: Your child’s digestive system may have a hard time breaking down and absorbing nutrients from the foods they eat. They may have fat, carbohydrate, protein, or vitamin, mineral, and trace element malabsorption.
• Intestinal polyps: Also called juvenile polyps, these are growths in the lining of the intestines. They can cause bleeding and pain. Though most are non-cancerous, they can increase your child’s risk of cancer later in life.
• Peptic ulcer disease: Open sores in the digestive system caused by acid. They include gastric ulcers in the stomach and duodenal ulcers at the start of the small intestine.
• Short bowel syndrome (SBS): This rare condition happens when surgery removes at least half of the small intestine and/or part of the large intestine. It affects how the body digests food and absorbs nutrients. Your child may develop SBS after surgery to treat another digestive condition.
• Ongoing GI symptoms: We help treat and manage chronic constipation, chronic diarrhea, chronic incontinence, and chronic abdominal pain. We also treat fecal incontinence, leaking stool. 

Pediatric functional digestive disorders

Your child’s brain can send faulty signals to their digestive system causing symptoms. These disorders we treat include:

• Functional abdominal pain: The most common functional digestive disorder in kids and teens. The pain is often severe and can cause them to miss school or other activities. It includes chronic abdominal pain and recurrent abdominal pain—3 or more episodes in 3 months in children aged 4 – 16.
• Cyclic vomiting syndrome (CVS): CVS means your child has frequent episodes of intense nausea and vomiting. These can last for a few hours to a few days and aren't caused by an illness. CVS happens most often in pre-school or early-school age children.
• Abdominal migraine: This type of migraine affects mostly children, often younger than age 10. It causes episodes of abdominal pain, nausea, and vomiting that can last from 2 – 72 hours. Headache is often not a symptom.
• Functional dyspepsia: Also called indigestion, this causes pain and a feeling of fullness in the upper abdomen.
• Irritable bowel syndrome: IBS is a condition that can come and go. It causes belly pain, gas, and bowel problems like constipation, diarrhea, or both.

Nutritional and growth concerns

We treat nutritional and GI problems related to other health issues, including:

• Eating disorders: In conjunction with mental health services, we provide nutritional support for patients with eating disorders.
• Childhood obesity: Extra body fat can cause a range of GI problems in kids and teens. This includes liver problems, gallstones, heartburn, and acid reflux. 

Liver problems

The liver plays many important roles in the body. It helps remove toxins, stores energy, and controls blood clotting. Problems with your child’s liver health we care for include:

• Hepatitis: Inflammation of the liver. This includes acute and chronic hepatitis and autoimmune hepatitis. Viruses, certain medicines, alcohol, immune system problems, and not getting enough blood to the liver can cause it. Hepatitis A, B, and C are common causes of viral hepatitis.
• Metabolic dysfunction-associated steatotic liver disease (MASLD): MASLD was called non-alcoholic fatty liver disease. It’s a buildup of fat in the liver. It’s found in people who have diabetes, obesity, high cholesterol, and high blood pressure who drink little to no alcohol.
• Cholestatic diseases: These conditions happen when bile flow from the liver is slowed or blocked.
• Drug-induced liver injury: Certain medications your child takes may cause DILI. Acetaminophen is the most common medicine that can damage the liver. It’s found in children’s over-the-counter and prescription painkillers and cold and flu medicines. The liver often recovers once the medication is stopped.
• Liver failure: When the liver stops working or has severe problems in how it works. It can happen suddenly from an injury or illness, called acute liver failure. It can also develop over a period of time from another liver disease, called chronic liver failure.

Anorectal disorders

We treat problems in your child’s anal and rectal areas. This includes: 

• Fissures: Cracks or tears in the inside lining of the anus.
• Fistula: An abnormal tunnel-like connection that forms in your anus. It travels through your anal wall to the skin outside. 
• Anal or rectal prolapse: When the lining of the rectum slips out through the anus. The rectum is the last part of the large intestine.
• Hemorrhoids: Swollen veins in the anus and rectum.
• Anal skin tags: Small, non-cancerous growths around the skin of the anus. They often happen with or after fissures or hemorrhoids.

Figuring out what’s causing your child’s digestive symptoms often takes time and different types of blood, tissue samples, and imaging tests. We have the training and skill to use these tools to diagnose the youngest of children.

Tests and procedures we use to diagnose digestive problems include:

• Anorectal manometry: Measures anal sphincter muscle pressure, rectal sensation, and the nerve reflexes needed for normal bowel movements. It helps diagnose constipation and fecal incontinence.
• Breath hydrogen testing: Measures the hydrogen in a breath sample to help diagnose bacterial overgrowth and other digestive conditions.
• Capsule endoscopy: A tiny pill-sized camera captures images of the digestive tract over 8 – 12 hours. It can help find the cause of GI bleeding and diagnose conditions such as Crohn's disease and celiac disease. The capsule passes naturally through the stool.
• Colonoscopy with biopsy: A thin, flexible scope with a camera is inserted through the anus to examine the colon and rectum. During the procedure, polyps can be removed, and tissue samples (biopsies) can be taken for testing.
• Esophageal string test: A minimally invasive test that checks how the esophagus is reacting to treatment for eosinophilic esophagitis (EoE). Instead of having an endoscopy, this simple test can show if there's still inflammation or active disease in the esophagus.
• Esophagogastroduodenoscopy with biopsy: A thin, flexible tube with a camera, called an endoscope, is passed through the mouth to examine the esophagus, stomach, and duodenum. Tissue samples can be collected for testing. This procedure is also called an upper endoscopy.
• Liver biopsy: A thin, hollow needle is used to remove a small tissue sample from the liver for testing.
• Rectal suction biopsy: A special tool collects a small tissue sample from the rectum to help diagnose Hirschsprung's disease.
• 24-hour pH/Impedance studies: A thin tube with sensors is placed through the nose into the esophagus to measure acid reflux and the movement of liquid and gas in the esophagus.

We offer a range of treatments to help children with digestive conditions get the nutrition they need, relieve symptoms, and improve their quality of life. Our care plans are tailored to each child's condition and may include nutrition support, medications, procedures, or surgery.

Nutrition support

Good nutrition is an important part of treating many digestive conditions. We provide:

• Nutrition counseling: Personalized guidance to help children get the nutrients they need for healthy growth and development.
• Total parenteral nutrition (TPN) management: Long-term management of intravenous nutrition for children who cannot absorb enough nutrients through their digestive tract.
• Enteral feeding and feeding tube management: Evaluation, placement, and ongoing care for feeding tubes when children cannot meet their nutritional needs by eating. This includes gastrostomy (G-tubes) and nasogastric (NG) tubes.

Procedures and surgery

Some digestive conditions require minimally invasive procedures or surgery. We work alongside our pediatric surgery team to manage:

• Gastrointestinal polyp removal: Removal of abnormal growths from the digestive tract.
• Gastrojejunostomy: A procedure that connects the stomach to the jejunum to bypass certain blockages in the digestive tract.
• Gastrointestinal bleeding management: Endoscopic procedures and other treatments to diagnose and control bleeding in the digestive tract.