Gastrointestinal disorders are among the most common complaints in children and young adults. In any given week, nearly 40% of school-children report abdominal pain, and another 35% report nausea, vomiting or constipation.

At Holtz Children’s Hospital, our experienced team of pediatric gastroenterologists provide care for children suffering from gastrointestinal, liver, pancreatic, nutritional disorders and gastrointestinal motility disorders. Areas of expertise include inflammatory bowel disease, liver disease, liver transplantation, nutritional failure, intestinal failure and motility.

Medical Conditions Treated

  • Abdominal Pain
  • Anorectal disorders
  • Bleeding in the Gastrointestinal Tract
  • Celiac Disease
  • Complex congenital malformations – anorectal & esophageal
  • Constipation and Diarrhea
  • Esophageal Achalasia
  • Fecal Incontinence
  • Feeding Disorders
  • Food Allergies
  • Gastroesophageal Reflux (GERD)
  • Gastroparesis
  • Hepatitis
  • Inflammatory Bowel Disease
  • Intestinal pseudo-obstruction syndrome
  • Lactose Intolerance
  • Liver Disease
  • Motility Disorders
  • Nutritional Problems
  • Pancreatic Insufficiency
  • Short Bowel Syndrome
  • Vomiting

Tests, Treatments & Procedures

When children require a liver or intestinal transplant or more routine abdominal surgery, pediatric gastroenterologists work closely with pediatric surgeons to ensure that patients receive the best possible care.

Colonoscopy
A colonoscopy allows a doctor to look into the large intestine with a narrow, flexible tune that has a camera on the end to determine why children have diarrhea, intestinal bleeding, weight loss and other conditions.

Liver Biopsy
A liver biopsy is a procedure performed using a special needle to obtain a sample of the liver. Liver biopsies help physicians evaluate jaundice, liver inflammation or an englarged liver.

pH Probe Study
Oftentimes, when acid reflux is suspected, a doctor will measure the pH of the esophagus to determine whether acid is refluxing up from the stomach into the esophagus. The procedure is also performed to determine the effectiveness of anti-reflux treatment and to offer an explanation for conditions such as nighttime cough and hoarseness. The procedure includes inserting a thin, plastic tube mounted with a sensor through the nostril and into the esophagus. A chest x-ray assesses the position of the tube, connected to a recorder and the probe remains in place for the 24-hour study. The child may return home for the study or remain in the hospital.

Upper Endoscopy
An upper endoscopy is a procedure to determine why children have abdominal pain, diarrhea, vomiting or poor growth. A small, narrow tube mounted with a light and camera is inserted into the swallowing tube of a child to evaluate the tube, stomach and upper small intestine.

Advanced Intestinal Rehabilitation Program

Holtz Children’s Hospital has one of the few multidisciplinary Intestinal Rehabilitation Programs in the United States. The program cares for children with intestinal failure, generally caused by short bowel syndrome. Short bowel syndrome is a complex and often devastating disorder caused by the loss of part of the small bowel and the decreased ability of the intestine to absorb nutrition. The loss of bowel can be due to congenital diseases or surgical removal.

Treatment
Treatment consists primarily of specialized nutrition management aimed at helping the remaining intestines adapt and take on the absorption functions that were lost. Most of these patients depend on parental nutrition. Before the creation of this program, the only option for these patients was intestinal/liver transplant. With the new program, transplant is an option for patients who fail home parental nutrition therapy.

Multidisciplinary Rehabilitation Team

  • Board-certified Pediatric Gastroenterologist
  • Pediatric Surgeons
  • Transplant Surgeons
  • Nurse Practitioner
  • Registered Dietitian
  • Medical Assistant
  • Research Assistant
  • Social Worker
  • Pharmacist
  • Child Psychologist

Comprehensive Gastrointestinal Motility & Abdominal Pain Center

“Motility” is a term used to describe the contraction of the muscles that mix and propel contents in the gastrointestinal (GI) tract. Any abnormality in the gut muscle and/or nerves, whether from birth or acquired, can disrupt the normal contractions and produce symptoms. These can include difficulty swallowing, choking, gagging, aspirating, vomiting, regurgitation, chest pain, abdominal pain or distension, constipation, diarrhea, incontinence or soiling, and weight loss. Motility disorders of the gut can also occur in association with abnormalities in other organ systems such as the central nervous system, mitochondrial disorders, muscular dystrophies and others. The prolonged suffering from these symptoms, with no proper diagnosis, can be both emotionally and physically stressful.

At the Comprehensive Motility & Abdominal Pain Center at Holtz Children’s Hospital, we are dedicated to giving our patients and families answers through unique diagnostic and treatment options. Led by our world-renowned pediatric motility specialists, our team uses a multidisciplinary approach, which may include nutritionists, psychologists, social work, child life specialists and complementary medicine when appropriate.

At Holtz Children’s Hospital, we perform the following motility testing and therapies:

Testing

  • Esophageal manometry
  • Antroduodenal manometry
  • Anorectal manometry
  • Colonic manometry
  • 24 hours pH-impedance study
  • Gastric emptying studies

Therapies

  • Internal anal sphincter chemodenervation with botulinum toxin
  • Endoscopic pyloric injection of botulinum toxin
  • Endoscopic lower esophageal injection of botulinum toxin
  • Esophageal balloon dilatation
  • Biofeedback
  • Antegrade continence enema surgery