Pediatric Gastroenterology

Pediatric Gastroenterology Department at Ankura Hospitals deals with the problems of the digestive system, liver, and nutrition in children from birth until 18 years of age. Organs that can be affected by these problems are gastrointestinal tract (esophagus, stomach, small intestine and large intestine including rectum), liver, biliary system, pancreas and spleen. Gastroenterology problems in children are quite different from those seen in adults in their presentation, cause, and treatment. So children suffering from gastroenterology related issues need care under a pediatric gastroenterologist who is specifically trained and has the experience to deal with these diseases and to perform endoscopy/colonoscopy in children.

Gastrointestinal diseases are some of the most common causes of morbidity and mortality among children. A pediatric gastroenterologist deals with the diagnosis, medical treatment, nutrition, and upper gastrointestinal endoscopy and colonoscopy procedures (for diagnosis and treatment purposes) in children.

Complaints and diseases which are treated under this specialty are as follows:

Esophagus: Child may have the problem of vomiting, difficulty or pain while eating, burning sensation in chest or blood in vomiting. Diseases of the esophagus include esophageal strictures which can be due to post trachea-esophageal fistula repair, corrosive (acid or alkali)/button battery ingestion, congenital and peptic stricture. Other diseases of the esophagus are infantile regurgitation, gastroesophageal reflux disease (reflux or GERD) achalasia cardia, eosinophilic esophagitis, rumination syndrome, etc. Other than these a child with the swallowed foreign body may require endoscopy for removal of the object to prevent further harm.

Stomach: Usual symptoms are pain abdomen, vomiting with or without blood and abdominal fullness. Diseases involving stomach are gastritis, peptic ulcer, Helicobacter pylori infection, gastric outlet obstruction, etc.

Small intestine: Symptoms are pain abdomen, yellowish-green vomiting, abdominal distension, borborygmi (excessive sound from the abdomen which can be heard outside), loose stools (acute and chronic diarrhea) and blood in stools. Diseases which affect small intestine are celiac disease, tropical sprue, abdominal tuberculosis, Crohn’s disease, immunodeficiencies (like IgA deficiency and CVID), vasculitis, etc.

Large intestine: Child complains of constipation, blood in stool, painful defecation and abdominal distension. Diseases affecting large intestine are dysentery, inflammatory bowel disease (Ulcerative colitis and Crohn’s disease), abdominal tuberculosis, gastrointestinal polyps, functional constipation, etc.

Liver and biliary system: Child may have complaints of loss of appetite, vomiting, jaundice, drowsiness, fever, pain abdomen, pale stools, blood in vomitus and stool, black stools, fluid in the abdomen, palpable mass in the abdomen, visible veins over abdomen. Diseases of the liver include liver abscess, neonatal cholestasis (biliary atresia, metabolic liver diseases), acute liver failure, cirrhosis, Wilson disease, Autoimmune liver disease, Hepatitis B and C, extrahepatic portal vein obstruction, storage disorders, liver tumors, etc. Diseases of the biliary system include gall stones, choledochal cyst, etc.

Pancreas: Child may have pain abdomen (often severe), oil in stool, not growing well and diabetes. Diseases are acute pancreatitis, chronic pancreatitis, pancreatic trauma, pancreatic insufficiency, etc.

Multiple diseases can be diagnosed and managed with the help of endoscopy. Esophageal stricture, blood in vomitus, pain abdomen, chronic diarrhea and blood in stool are few of them.

Other diseases related to lifestyle and eating behavior in children like obesity and malnutrition are also dealt with under this specialty.

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