Pediatric Gastroenterologist Conditions We Treat
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GERD / Acid Reflux
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Peptic Ulcers
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Infant Colic & Vomiting
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Paediatric Constipation & Diarrhoea
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Celiac Disease & Lactose Intolerance
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Paediatric Inflammatory Bowel Disease (IBD) – Crohn’s & Ulcerative Colitis
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Paediatric Liver Disorders
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Failure to Thrive & Nutritional Deficiencies
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Food Allergies / Intolerances
GERD / Acid Reflux
Overview
Gastro-oesophageal Reflux Disease (GERD) occurs when stomach acid flows back into a child’s oesophagus frequently, causing irritation and discomfort. While occasional reflux is normal in infants, persistent symptoms in older children or adolescents may indicate GERD that requires medical care. Untreated GERD can affect growth, nutrition, and overall well-being.
Symptoms
- Frequent vomiting or regurgitation: Infants may spit up often, and older children may notice a sour or bitter taste in the mouth. Persistent episodes can disrupt feeding and comfort.
- Burning chest pain or heartburn: Older children and teenagers may experience a burning sensation in the chest, often worse after meals or when lying down.
- Chronic cough, throat irritation, or hoarseness: Acid can irritate the throat and airway, sometimes causing a persistent cough, hoarseness, or wheezing.
- Feeding difficulties or food refusal: Some children avoid eating due to discomfort, which can lead to picky eating and poor appetite.
- Poor weight gain or growth delay: Severe GERD may interfere with nutrition, potentially affecting height and weight development over time.
Diagnosis
- Child-friendly endoscopy: A small camera examines the oesophagus directly, allowing doctors to check for inflammation, narrowing, or other abnormalities.
- Oesophageal pH monitoring: This 24-hour test measures acid levels in the oesophagus to confirm the frequency and severity of reflux episodes.
- Oesophageal manometry: Evaluates how well the oesophageal muscles are working and helps rule out motility disorders.
- Growth and nutrition assessment: Regular monitoring of weight, height, and nutritional intake identifies the impact of reflux on overall development.
Treatment
- Lifestyle and feeding modifications: Small, frequent meals, keeping the child upright after feeding, and avoiding spicy, fatty, or acidic foods can significantly reduce reflux episodes.
- Acid suppression therapy: Medications such as proton pump inhibitors (PPIs) or H2 blockers may be prescribed in moderate to severe cases to reduce acid and protect the oesophagus.
- Nutritional guidance: Ensuring the child receives adequate calories and nutrients while minimising reflux triggers helps support healthy growth.
- Surgical management: In rare cases where medication is ineffective, minimally invasive procedures like fundoplication may be considered.
Peptic Ulcers in Children
Overview
Peptic ulcers are open sores that develop on the lining of the stomach or the first part of the small intestine (duodenum). In children, they may result from Helicobacter pylori infection, prolonged NSAID use, or excessive stomach acid production. Early recognition and treatment are essential to prevent complications and support healthy growth.
Symptoms
- Burning or gnawing abdominal pain: Typically felt in the upper abdomen, often worse at night or on an empty stomach. Pain may improve temporarily after eating.
- Nausea or vomiting: Some children vomit frequently, and in severe cases, vomit may contain traces of blood, which requires urgent attention.
- Bloating or early fullness: Children may feel full after eating small amounts, leading to reduced food intake.
- Unexplained weight loss or poor appetite: Persistent pain and nausea can affect growth and overall nutrition.
- Blood in stools: Dark, tarry stools may indicate bleeding from an ulcer and must be assessed immediately.
Diagnosis
- Child-friendly upper endoscopy: A small camera examines the stomach and duodenum directly, with biopsies taken if necessary to confirm the ulcer.
- Testing for H. pylori: Breath, stool antigen, or biopsy tests help identify bacterial infection as the underlying cause.
- Blood tests: Check for anaemia or nutritional deficiencies caused by bleeding or poor absorption.
- Imaging studies: Ultrasound or X-rays may be used in complex or unclear cases to visualise the gastrointestinal tract.
Treatment
- Antibiotic therapy: Prescribed when H. pylori infection is detected, typically a combination of two antibiotics to eradicate the bacteria.
- Acid suppression therapy: Proton pump inhibitors (PPIs) or H2 blockers reduce stomach acid and promote healing of the ulcer.
- Lifestyle and dietary changes: Avoiding spicy foods, caffeine, and NSAIDs, and maintaining a balanced, child-friendly diet supports recovery.
- Monitoring and follow-up: Regular check-ups ensure the ulcer is healing properly and help detect any recurrence early.
Infant Colic & Vomiting
Overview
Infant colic involves frequent, prolonged crying and irritability in otherwise healthy babies, often starting within the first few weeks of life. While occasional vomiting is common, persistent or forceful vomiting may signal an underlying gastrointestinal issue requiring medical evaluation. Early recognition helps ensure proper growth and comfort for both baby and parents.
Symptoms
- Excessive crying and irritability: Typically occurs in the late afternoon or evening, often lasting several hours, with no apparent cause.
- Frequent spitting up or vomiting: More than occasional regurgitation after feeds; may be distressing for both infant and caregiver.
- Pulling legs towards the abdomen: Indicates abdominal discomfort or cramping during colic episodes.
- Feeding or sleeping difficulties: Babies may refuse feeds or wake frequently due to discomfort, affecting growth and sleep patterns.
- Warning signs for urgent care: Projectile vomiting, blood in vomit, poor weight gain, dehydration, or lethargy require immediate medical attention.
Diagnosis
- Clinical history and feeding assessment: Reviews feeding techniques, formula type, and maternal diet in breastfed infants.
- Growth and nutrition checks: Monitoring weight, length, and hydration ensures normal development is maintained.
- Allergy or intolerance testing: Considered if lactose intolerance or cow’s milk protein allergy is suspected.
- Imaging or endoscopy (rare cases): Used to exclude anatomical conditions such as pyloric stenosis or intestinal obstruction.
Treatment
- Feeding modifications: Smaller, more frequent feeds, upright positioning during and after feeding, or hypoallergenic formulas if necessary.
- Burping techniques: Frequent burping during feeds to reduce swallowed air and discomfort.
- Medications (select cases): Acid suppression therapy may be considered under specialist supervision if reflux contributes to vomiting.
- Nutritional guidance: Adjustments to maternal diet in breastfeeding, and ensuring adequate caloric intake for the infant.
- Parental support and reassurance: Education and counselling help families manage colic episodes and reduce anxiety.
Paediatric Liver Disorders
Overview
Paediatric liver disorders encompass a range of conditions that affect liver function, including congenital, genetic, infectious, autoimmune, and metabolic causes. The liver plays a critical role in digestion, detoxification, and energy storage. Early recognition and treatment are essential because liver disease in children can impact growth, development, and long-term health.
Symptoms
- Jaundice: Yellowing of the skin and eyes, often the first visible sign of liver dysfunction.
- Abdominal swelling or pain: May result from liver enlargement, fluid accumulation, or inflammation.
- Persistent fatigue or weakness: Reduced energy levels can occur due to impaired metabolism and energy storage.
- Dark urine or pale stools: Indicates bile flow obstruction or impaired liver function.
- Poor appetite and growth delays: Inadequate digestion and nutrient absorption can affect normal growth and development.
Diagnosis
- Blood tests: Liver function tests measure enzyme levels, bilirubin, and clotting factors to evaluate liver health.
- Ultrasound or MRI scans: Imaging identifies liver enlargement, scarring, or structural abnormalities.
- Liver biopsy: A small tissue sample is examined to assess inflammation, scarring, or specific liver conditions.
- Genetic and metabolic testing: Detects hereditary liver diseases or enzyme deficiencies.
Treatment
- Medications: Prescribed to reduce inflammation, fight infections, or manage autoimmune-related liver disease.
- Nutritional therapy: Special diets and supplements support growth and reduce strain on the liver.
- Minimally invasive procedures or surgery: Correct bile duct blockages or remove damaged tissue when required.
- Liver transplantation: Considered in severe or end-stage liver disease when other treatments are ineffective.
- Long-term monitoring: Regular follow-up ensures liver function and overall health are protected as children grow.
Celiac Disease & Lactose Intolerance
Overview
Celiac disease and lactose intolerance both affect how a child digests and absorbs food, but their causes differ. Celiac disease is an autoimmune condition where gluten (found in wheat, barley, and rye) damages the small intestine, reducing nutrient absorption. Lactose intolerance occurs when the body lacks enough lactase, the enzyme required to digest lactose, the sugar in milk. Early diagnosis and management help children thrive while preventing growth and nutritional complications.
Symptoms
- Celiac disease: Chronic diarrhoea or constipation, bloating, abdominal cramps, and poor weight gain or unexplained weight loss are common. Fatigue, irritability, and delayed growth may also occur.
- Nutritional deficiencies in celiac disease: Children may develop anaemia or vitamin deficiencies due to malabsorption.
- Lactose intolerance: Gas, bloating, abdominal pain, and loose stools often occur after consuming dairy products.
- Nausea or discomfort: Symptoms typically improve when dairy or gluten is removed from the diet.
- Growth and development impact: Untreated conditions can affect overall growth, energy, and quality of life.
Diagnosis
- Blood tests: Antibody testing (tTG-IgA) for suspected celiac disease, along with nutritional panels to check for deficiencies.
- Endoscopy with biopsy: Gold standard for confirming celiac disease and assessing intestinal damage.
- Lactose tolerance tests: Hydrogen breath test or elimination diet to confirm lactose intolerance.
- Growth and nutrition monitoring: Regular tracking of weight, height, and development ensures adequate nutrition.
Treatment
- Celiac disease management: Lifelong gluten-free diet, nutritional counselling, and supplementation for iron, calcium, vitamin D, or other deficiencies.
- Lactose intolerance management: Avoiding or reducing lactose-containing foods, using lactase enzyme supplements, and ensuring adequate calcium and vitamin D from safe sources.
- Dietary support: Tailored meal planning ensures balanced nutrition while avoiding triggers.
- Regular follow-up: Ongoing monitoring of growth, nutrient status, and symptom control to prevent complications.
- Parental guidance: Education and counselling to support adherence to dietary restrictions and maintain quality of life.
Paediatric Liver Disorders
Overview
Paediatric liver disorders encompass a range of conditions that affect liver function, including congenital, genetic, infectious, autoimmune, and metabolic causes. The liver plays a critical role in digestion, detoxification, and energy storage. Early recognition and treatment are essential because liver disease in children can impact growth, development, and long-term health.
Symptoms
- Jaundice: Yellowing of the skin and eyes, often the first visible sign of liver dysfunction.
- Abdominal swelling or pain: May result from liver enlargement, fluid accumulation, or inflammation.
- Persistent fatigue or weakness: Reduced energy levels can occur due to impaired metabolism and energy storage.
- Dark urine or pale stools: Indicates bile flow obstruction or impaired liver function.
- Poor appetite and growth delays: Inadequate digestion and nutrient absorption can affect normal growth and development.
Diagnosis
- Blood tests: Liver function tests measure enzyme levels, bilirubin, and clotting factors to evaluate liver health.
- Ultrasound or MRI scans: Imaging identifies liver enlargement, scarring, or structural abnormalities.
- Liver biopsy: A small tissue sample is examined to assess inflammation, scarring, or specific liver conditions.
- Genetic and metabolic testing: Detects hereditary liver diseases or enzyme deficiencies.
Treatment
- Medications: Prescribed to reduce inflammation, fight infections, or manage autoimmune-related liver disease.
- Nutritional therapy: Special diets and supplements support growth and reduce strain on the liver.
- Minimally invasive procedures or surgery: Correct bile duct blockages or remove damaged tissue when required.
- Liver transplantation: Considered in severe or end-stage liver disease when other treatments are ineffective.
- Long-term monitoring: Regular follow-up ensures liver function and overall health are protected as children grow.
Paediatric Liver Disorders
Overview
Paediatric liver disorders encompass a range of conditions that affect liver function, including congenital, genetic, infectious, autoimmune, and metabolic causes. The liver plays a critical role in digestion, detoxification, and energy storage. Early recognition and treatment are essential because liver disease in children can impact growth, development, and long-term health.
Symptoms
- Jaundice: Yellowing of the skin and eyes, often the first visible sign of liver dysfunction.
- Abdominal swelling or pain: May result from liver enlargement, fluid accumulation, or inflammation.
- Persistent fatigue or weakness: Reduced energy levels can occur due to impaired metabolism and energy storage.
- Dark urine or pale stools: Indicates bile flow obstruction or impaired liver function.
- Poor appetite and growth delays: Inadequate digestion and nutrient absorption can affect normal growth and development.
Diagnosis
- Blood tests: Liver function tests measure enzyme levels, bilirubin, and clotting factors to evaluate liver health.
- Ultrasound or MRI scans: Imaging identifies liver enlargement, scarring, or structural abnormalities.
- Liver biopsy: A small tissue sample is examined to assess inflammation, scarring, or specific liver conditions.
- Genetic and metabolic testing: Detects hereditary liver diseases or enzyme deficiencies.
Treatment
- Medications: Prescribed to reduce inflammation, fight infections, or manage autoimmune-related liver disease.
- Nutritional therapy: Special diets and supplements support growth and reduce strain on the liver.
- Minimally invasive procedures or surgery: Correct bile duct blockages or remove damaged tissue when required.
- Liver transplantation: Considered in severe or end-stage liver disease when other treatments are ineffective.
- Long-term monitoring: Regular follow-up ensures liver function and overall health are protected as children grow.
Failure to Thrive & Nutritional Deficiencies
Overview
Failure to Thrive (FTT) refers to inadequate growth and insufficient weight gain in infants and children compared to expected growth standards. Causes include nutritional deficiencies, chronic digestive disorders, metabolic conditions, or feeding and absorption difficulties. Early evaluation and intervention are crucial to support physical, cognitive, and emotional development.
Symptoms
- Poor weight gain or growth delays: Children may consistently fall below standard growth charts for their age.
- Loss of appetite or feeding difficulties: Difficulty eating, swallowing, or digesting food may reduce caloric intake.
- Fatigue and low energy: Insufficient nutrition can lead to tiredness and reduced activity.
- Frequent illnesses or infections: Weak immunity from poor nutrition may increase susceptibility to infections.
- Developmental delays: Slower achievement of milestones such as walking, talking, or learning may occur.
Diagnosis
- Growth tracking: Regular monitoring of height, weight, and head circumference over time.
- Blood tests: Detect anaemia, vitamin and mineral deficiencies, or underlying medical conditions.
- Stool studies: Evaluate digestion and nutrient absorption.
- Dietary assessments: Review calorie intake, feeding habits, and diet quality.
- Endoscopy or imaging: Used if a digestive disorder such as reflux, celiac disease, or IBD is suspected.
Treatment
- Nutritional rehabilitation: Tailored diet plans with calorie- and nutrient-dense foods to promote catch-up growth.
- Supplements: Iron, calcium, vitamin D, or other micronutrients as required to correct deficiencies.
- Feeding therapy: Support for children with oral-motor or swallowing difficulties.
- Treating underlying causes: Management of digestive, metabolic, or chronic illnesses contributing to poor growth.
- Parental counselling: Guidance on structured feeding routines and age-appropriate diets to ensure long-term nutritional support.
Food Allergies / Intolerances
Overview
Food allergies and intolerances in children can significantly affect daily life and long-term health. A food allergy occurs when the immune system overreacts to a harmless food protein, potentially causing mild to severe reactions. Food intolerance generally involves the digestive system, leading to discomfort without triggering an immune response. Common triggers include milk, eggs, soy, wheat, nuts, and shellfish. Early recognition and management are crucial for safe nutrition and growth.
Symptoms
- Food allergy reactions: Hives, itching, swelling of lips or tongue, abdominal cramps, vomiting, wheezing, or, in severe cases, anaphylaxis.
- Food intolerance symptoms: Bloating, diarrhoea, gas, abdominal pain, or nausea after consuming certain foods.
- Poor growth or malnutrition: Restricted diets without proper nutritional guidance can affect growth and development.
- Chronic issues: Recurring eczema, persistent cough, or reflux-like symptoms may sometimes be linked to food sensitivities.
- Diet-related discomfort: Symptoms typically resolve when the offending food is eliminated, highlighting the importance of correct diagnosis.
Diagnosis
- Detailed medical and dietary history: Identifies symptom patterns linked to food intake.
- Skin prick tests or blood tests (IgE): Detect immune-mediated food allergies.
- Food elimination and challenge diets: Systematic removal and reintroduction of foods under medical supervision to pinpoint triggers.
- Breath tests: For intolerances such as lactose or fructose malabsorption.
- Endoscopy: Used in cases of suspected allergic inflammation in the oesophagus or gut.
Treatment
- Strict avoidance: Eliminating confirmed allergenic foods from the child’s diet.
- Emergency action plans: Prescribing epinephrine auto-injectors for children at risk of severe allergic reactions.
- Dietary management: Ensuring children avoid problem foods while still meeting growth and nutritional needs.
- Enzyme replacement: Lactase supplements may help children with lactose intolerance digest dairy safely.
- Regular monitoring: Growth and nutritional status are closely tracked to prevent deficiencies.
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Gastroenterology FAQs
When should I see a Gastroenterologist?
You should visit a Gastroenterologist if you have persistent digestive issues like heartburn, bloating, constipation, diarrhoea, or unexplained abdominal pain.
What are the common causes of Acid Reflux (GERD)?
Acid reflux is often triggered by spicy foods, caffeine, alcohol, smoking, obesity, and late-night eating. Lifestyle changes and medication can help manage symptoms.
What are the signs of Liver Disease?
Symptoms include jaundice (yellowing of skin/eyes), fatigue, swelling in the legs, dark urine, and persistent nausea. Liver disease can be caused by infections, alcohol, or fatty liver.
What is a Colonoscopy, and when do I need one?
A Colonoscopy is a screening test for colon cancer and digestive disorders. It’s recommended if you’re over 45 or experiencing blood in stool, unexplained weight loss, or chronic diarrhea.
What foods help improve digestion?
Fiber-rich foods like fruits, vegetables, whole grains, and yogurt promote gut health, while processed foods, dairy, and fried foods may worsen digestive issues.
What are the symptoms of Gallbladder problems?
Common symptoms include severe pain after eating fatty foods, nausea, vomiting, and bloating. Gallbladder issues like gallstones may require dietary changes or medical treatment.
What is Hernia?
A Hernia occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall.
In many cases, it causes no or very few symptoms, although you may notice a swelling or lump in your tummy (abdomen) or groin.
The lump can often be pushed back in or disappears when you lie down. Coughing or straining may make the lump appear.
What is Cancer screening?
Cancer Screening is looking for cancer before a person has any symptoms. This can help find Cancer at an early stage. When abnormal tissue or Cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread.
What are the tests used to screen Colon Cancer?
The following types of tests are used to screen for Colorectal Cancer:
- Fecal occult blood test
- Sigmoidoscopy
- Colonoscopy
- CT Colonography
- CEA assay