1. What is a Pediatric Gastroenterologist?

Children are not just small adults. Their bodies are growing and have unique medical and nutritional requirements. Their symptoms of a health condition can be different from adults. Pediatric gastroenterologists focus on problems including growth, maturation, nutrition, digestion and age-related social issues.

If one's child has a digestive system, liver, or nutritional problem, a pediatric gastroenterologist has the training and skill to treat it. Problems related to digestion and nutrition including the esophagus, stomach, large bowel, small bowel, liver, gallbladder and pancreas in children can be quite different from those seen in adults. They cannot always answer questions by health professionals and maybe irritable and uncooperative. Pediatric gastroenterologists know the skill to manage children in a way that makes them relaxed and cooperative.

Pediatric gastroenterologists treat the age groups from newborn to the teenage. They choose their specialty so that they get extensive experience specifically in the care of infants, children, and teens.

The specialty of pediatric gastroenterology requires atleast five to six years of medical school and become a general doctor. Afterwards the student needs to take a three year of residency in pediatrics specialty. Afterwards specialization, students undergo three years of sub-specialty in pediatric gastroenterology.

2. When can you meet a pediatric gastroenterologist?

The development of gastrointestinal tract of child is related to the nutrition that the child or its mother receives. Nutritional problems can result in malnutrition, vitamin deficiency, anemia, failure to thrive, and obesity. Common nutrition related issues that can happen in childhood are:

• Iron deficiency anemia: is commonly encountered in new born child. This is caused when the only food that the baby receives is maternal milk which is low in iron. Supplementation is not needed in this period because iron will reach normal levels when weaning to solid foods. If the child doesnot accept the solid foods readily or suffer malnutrition due to any other cause, then gastric pediatricians, and not regular pediatricians, should be consulted to treat the anemia. They will know the correct dosages and methods to recover the iron levels without causing any side effects in the gastrointestinal system.
• Overweight or underweight: these are caused by an imbalance in the amount of calories consumed and the calories burned. Both in children should be treated by a gastric pediatrician and a pediatric nutritionist at the same time to help the child recover his normal weight without secondary effects (hypertension, gastritis, etc.). The nutritionist will make a diet plan for the child, however, the pediatric gastroenterologist will be the one correlating the diet changes with the correct functionality of the digestive system.

Chronic or severe diseases of child's digestive system need to be specifically treated by a Pediatric gastroenterologist. The following are two of the most common ones:

• Acute diarrhea: Every child experiences an average of 7-30 episodes of diarrhea in the first 5 years of life. Some of the causes are infections, low levels of zinc or under-development of stomach.
• Infant regurgitation: is caused by a reflex mechanism in which gastric contents are forcefully expelled through the mouth because of coordinated movements of the small bowel, stomach, esophagus, and diaphragm. The usual scenario includes the child between 1 and 12 years of age having regurgitation two or more times per day for three or more weeks, and the symptoms include bloddy vomiting, choking of windpipe, skipping a few breaths, failure to gain normal weight, or abnormal posturing. This is transient problem, possibly due to the immaturity of gastrointestinal motility.

Other conditions generally managed by pediatric gastroenterologists are:

• Gastero-intestinal bleeding may present as blood in stools, black/tarry stools or occult blood on stool tests. It can happen from many causes and may be self-limiting or life-threatening.
• Lactose intolerance in which children develop symptoms like diarhea, bloating, inability to gain weight. It can happen due to intolerance to lactose in milk.
• Food allergies or intolerances that may present with skin rash, difficulty breathing and other symptoms of immune reaction to foods like peanuts, egg, milk, etc
• Severe or complicated gastroesophageal reflux disease (reflux or GERD) can present with heart burn, dry cough, trouble swallowing etc.
• Inflammatory bowel disease causes parts of intestine to get swollen. It can cause bouts of bloody diarrhea and weight loss in children.
• Short bowel syndrome can happen after surgical removal of short bowel. It can present with failure to gain weight and diarrhea.
• Liver diseases can be of many different types like acute liver failure, autoimmune liver disease, alpha 1 anti trypsin deficiency, cystic fibrosis, hepatitis etc.
• Acute or chronic abdominal pain maybe caused by many conditions like surgical abdomen, irritable bowel syndrome, celiac disease, colic in infants, etc.
• Vomiting is mostly caused by gastro enteritis, 'stomach flu' in children. Other causes could be regurgitated breast milk in babies, food poisoning, food allergy, etc.
• Chronic constipation could happen due to improper toilet training, loss of fluids or inadequate fluid intake, etc.
• Chronic or severe diarrhea could happen due to infectious gastroenteritis, food intolerance, food allergy, etc.
• Pancreatic insufficiency (including cystic fibrosis) and pancreatitis
• Feeding disorders like picky eaters, etc could happen due to discomfort during eating, vomiting during feeding, temperament of child, anxieties, autism, etc.
• Pediatric gastroenterologists have special training to perform diagnostic tests of a child's gastrointestinal system. Special instruments, such as endoscopes, are used to examine the inside of the gastrointestinal tract or obtain biopsies. Endoscopic procedures include esophagogastroduodenoscopy and colonoscopy.

3. Where is a Pediatric Gastroenterologist available?

Pediatric gastroenterologists practice in a variety of medical settings including children's hospitals, medical colleges, and large hospitals, as well as private offices or private practices.

It is important that their help is sought as soon as the case needs their requirement. Pediatricians are well trained for all pediatric conditions but they may not be able to manage chronic and severe diseases.

Our AskADoctor has its very pediatric gatroenterologist. With the above information, one can book a consultation with an online pediatric gastroenterologist for further clarity.