Gastroenterology + Digestive Health (Pediatrics)

We work closely with pediatric ENT and speech language pathology specialists to evaluate feeding and swallowing disorders in children.

We help infants, children and adolescents with liver, gallbladder and bile duct disorders. Liver conditions can range from mild to serious.

Our care philosophy puts the family at the center and accesses a wide-range of specialties such as newborn medicine, genetics, pediatric radiology, clinical nutrition, and others. We care for:

• Acute liver failure
• Alagille’s syndrome
• Alpha-1 antitrypsin deficiency
• Ascites
• Autoimmune hepatitis
• Biliary atresia
• Choldochal cyst
• Cirrhosis
• Drug-induced liver injury
• Hepatitis B and C
• Metabolic liver disease
• Neonatal cholestasis
• Neonatal hepatitis
• Non-alcoholic fatty liver disease 
• Other viral hepatides such as EBV, CMV
• Portal hypertension ( non-cirrhotic and cirrhotic)
• Portal vein thrombosis 
• Variceal bleeding 
• Wilson’s disease

It's important to catch celiac disease early so that your child can start feeling better as soon as possible. And with a gluten-free diet, your child can start feeling better within just a few days and sticking to the diet will help prevent any further damage to their intestine.

We know that living gluten-free can be challenging, but our team of registered dietitians is here to help. We'll work with you and your child to learn which foods are safe to eat, how to set up your kitchen, how to prepare meals, and even how to dine out.

We'll keep a close eye on your child's progress during the first few months of the diet to make sure they're getting better and gaining weight. After that, we'll typically see them every 6-12 months to make sure everything is going smoothly.

Together with our colleagues at Boston Children's Hospital, we provide care for children who have or are suspected of having food allergies or hypersensitivity that cause gastrointestinal disorders and other conditions, including:

• IgE mediated food allergies (e.g. peanut allergy, cow milk allergy and etc.)
• Eosinophilic esophagitis
• Eosinophilic gastrointestinal disorders
• Food protein-induced proctitis/colitis and enteropathy of infancy
• Food protein-induced enterocolitis syndrome (FPIES)
• Celiac disease
• Non-celiac gluten hypersensitivity
• Oral allergy syndrome
• Food-dependent exercise-induced anaphylaxis
• Lactose and fructose intolerance
• Abdominal pain associated with food ingestion
• Food aversion/phobia
• Allergic contact dermatitis

Children who have food allergies or gut disorders associated with food often experience a range of symptoms, from difficulty swallowing to severe anaphylaxis that can be life-threatening. We take a collaborative approach between  allergy, gastroenterology and clinical nutrition to help children manage their conditions and find relief from their symptoms.

We provide a range of specialized allergy studies that include supervised oral food challenges, skin prick tests, patch tests, and component-resolved diagnostics. Additionally, we offer GI studies such as breath tests to evaluate bacterial overgrowth, lactose and fructose intolerance, and H. pylori infection, as well as motility studies, video capsule endoscopy, and upper and lower endoscopies. For cases where specific food avoidance is critical, we have a registered dietitian available to provide same-day consultations.

Inflammatory bowel diseases (IBD) such as ulcerative colitis and Crohn's disease are becoming increasingly common in children — and are emerging at younger ages. We specialize in getting inflammatory bowel disease under control and have the expertise to reduce inflammation of the digestive tract so that your child can live a normal, more comfortable life.

IBD can be tough on a child. In addition to troubling day-to-day symptoms like diarrhea and abdominal pain, it can cause long-term problems such as growth failure, missed school days and an inability to participate in extracurricular and social activities. We are well-versed in the many medications available to treat IBD and the most promising therapies.

If your child is experiencing symptoms of inflammatory bowel disease, we'll try to see him or her promptly. At their first visit, we will review your child's medical history, results of previous tests and any other information that your pediatrician provides. If necessary, we may conduct further diagnostic testing such as endoscopies.

Once we confirm a diagnosis, we discuss treatment options with you. Conventional treatments include anti-inflammatory and immune-modulatory drugs along with antibiotics. We also may discuss clinical trials that offer access to promising new medications and clinical nutrition.

We can also connect you with psychological support, which helps some children deal with their health challenges.

An IBD transition program is important because it prepares your child for adult care and sets them up for success when they start seeing adult doctors. 

Our program helps your child become more independent in their healthcare, teaches them about their disease and needs and educates them about what to expect in an adult GI appointment. When the time comes, we'll work with you and your child to ensure a smooth transition to adult care. 

Our pediatric GI team and the adult GI team will meet to discuss the patient's medical history, and then schedule a joint appointment with both the primary pediatric GI doctor and the new adult GI doctor. With your family's consent, we'll make sure the transition is seamless, so your child can continue to receive the best care possible.
 

We all know how important it is for children to eat a healthy and balanced diet. If your little one is having any trouble with nutrition, we're here to lend a hand. Our friendly team specializes in improving the nutritional intake of children of all ages—from newborns to young adults. We understand that every child is unique, and we love creating personalized care plans that fit their specific needs. Let us help your child overcome any nutrition challenges they may be facing. Some of the challenges we can help with include:

• Failure to grow or thrive
• Feeding disorders
• Celiac disease or gluten intolerance
• Inflammatory bowel disease
• Irritable bowel syndrome
• Food allergies
• Home enteral (tube feeding) or parenteral (IV nutrition) feedings

During your child's first visit, we'll take the time to get to know your family and conduct a complete nutritional assessment. We want to understand your child's food preferences, recent eating habits, and explore their eating habits at home. We know that this can be a lot, but it's important to us that we get a complete picture of your child's feeding habits.

Based on our assessment, we may recommend that your child undergo further testing or visit a specialist outside our division. We'll work with you to develop a care plan that's tailored specifically to your child's unique needs. Your input as a parent is incredibly valuable to us! We want to understand your child's home life, personality, and day-to-day activities to ensure that our plan is effective and realistic.

We're here to provide you with specific guidance on various topics, such as nutrition and feeding habits. We want you to feel supported every step of the way! Our goal is to work with you to ensure that your child receives the best possible care and support. We're dedicated to your child's health and well-being, and we can't wait to be a part of your family's journey.

• Which foods are best for your child
• When and how to feed him or her
• Managing his or her behavior during meals

We make sure you feel confident with carrying out your child's care plan. And realize that managing major dietary and lifestyle changes takes much effort and patience. So we're available if you have questions or need someone to talk to.

Typically visits are 1-2 times a month for several months and then once a year to check in on a progress.

• www.Celiac.org
• www.Gikids.org
• www.glutenfreedrugs.com

• "The Poo in You"
• www.GIkids.org

• www.foodallergy.org

• www.Apfed.org
• www.GIkids.org
• www.foodallergy.org

• www.CCFA.org
• www.Justlikemeibd.org
• www.Gikids.org
• www.improvecarenow.org
• www.ibdetermined.org
• www.gibuddy.org