Digestive Health (Gastroenterology)

Abdominal pain in childhood is as predictable as loose teeth and skinned knees. But when digestive troubles start interfering with your child’s life, it’s time to speak with your child’s primary care doctor. He or she may refer you to the Nemours Division of Gastroenterology (Digestive Health).

Our board-certified doctors evaluate, diagnose, and treat a wide variety of digestive health conditions, from the routine to the complex. Our expert staff – which also includes several fellows (doctors receiving advanced training in pediatric gastroenterology), specialized nurse practitioners, and a team of highly trained nurses – provides personalized, comprehensive care on an inpatient or outpatient basis for children with such conditions as:

• gastroesophageal reflux disease (heartburn)
• constipation
• abdominal pain
• inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis
• celiac disease (intolerance to gluten protein)
• recurrent vomiting
• recurrent diarrhea
• disorders affecting nutrient absorption
• allergic diseases of the gastrointestinal system
• diseases of the liver or pancreas 
• feeding disorders
• gastrointestinal bleeding
• motility disorders (slow or rapid movement of the stomach or intestines)
• feeding intolerance requiring feeding tube placement (when a tube is inserted to deliver nutrition directly to the stomach via the nose – called a nasogastric, or NG tube – or through an opening in the abdomen – called a gastrostomy, or G tube)
  
• polyps
• liver disease requiring transplantation

Additionally, we have specialty programs dedicated to the care of children with specific chronic gastrointestinal conditions. These clinics allow for integrated, cooperative care supported by doctors, nurse practitioners, licensed clinical social workers, and registered dietitians, all working together in a child-centered environment.

Some digestive conditions require surgical intervention, and in these cases we will work closely with Nemours surgeons to ensure the most coordinated care. Our electronic medical record, called NemoursOne, allows all consulting doctors access to the latest information about your child’s medical care, test results, and plans for management.

What Can You Expect at a Visit?

Your child’s initial visit with us will include a thorough physical exam, medical and family history, and questions about the frequency and severity of your child’s symptoms.

Based on our findings, we may then perform further tests, such as:

• blood and urine tests
• specialized X-rays, such as an Upper GI study
  
• endoscopy (evaluating the esophagus, stomach, or intestines through a tiny scope). Typically this scope is inserted, under sedation, into your child’s upper digestive tract via the throat or into the intestines via the anus (colonoscopy), depending on what view is necessary.

However the Alfred I. duPont Hospital for Children in Wilmington, Delaware now offers a non-invasive alternative called wireless capsule endoscopy. Essentially a “camera in a pill,” this state-of-the-art procedure provides high-quality images in a less invasive way.  This technique allows doctors to see parts of the small intestine that are ordinarily difficult to evaluate using other techniques.

If your child needs traditional endoscopy of the upper digestive tract or a colonscopy, we’re pleased to offer access to an online educational program about the procedure that you can watch on any computer. Created by Emmi® Kids, this easy-to-use animated program will help you better understand the details of the surgical process and what to expect at every step. 

• pH probe studies (a test to check acid levels in the esophagus)
• intestinal manometry (a test to measure pressure and coordination of the intestine)
• breath testing (a test to look for lactose intolerance)
• intestinal or esophageal biopsy (removing a small sample of tissue for microscopic examination)

The goal of treatment is always to alleviate your child’s symptoms as quickly as possible, and, when necessary, to provide an ongoing management plan to maintain your child’s good digestive health.