When a child experiences ongoing stomach pain, digestive issues, or feeding problems, the answer may lie in a lesser-known specialty: pediatric gastroenterology. But what exactly does this field cover—and how is it different from adult care? Comprehending what pediatric gastroenterologists do could be the key to helping your child feel better, sooner than you think.
Need a gastroenterologist in Queens? Book an appointment now.
What Does a Pediatric Gastroenterologist Do?
A pediatric gastroenterologist is a highly trained medical specialist who focuses on diagnosing, treating, and managing disorders of the digestive system, liver, and nutritional health in children—from newborns to adolescents. These specialists bring a deep understanding of how digestive conditions uniquely affect growing bodies, offering care that is specifically tailored to children’s developmental needs.
Training and Expertise
To become a pediatric gastroenterologist, a physician must complete:
- 4 years of medical school
- 3 years of pediatric residency
- 3 additional years of fellowship training in pediatric gastroenterology, hepatology, and nutrition
This rigorous training prepares them to perform and interpret specialized procedures such as upper endoscopies (EGD), colonoscopies, and liver biopsies, as well as a range of diagnostic tests adapted for pediatric patients.
Conditions Treated
Pediatric gastroenterologists manage a broad spectrum of conditions, including:
- Gastroesophageal reflux disease (GERD)
- Inflammatory bowel diseases (IBD) like Crohn’s disease and ulcerative colitis
- Celiac disease
- Food allergies and intolerances
- Chronic constipation and diarrhea
- Abdominal pain and bloating
- Liver diseases, including hepatitis and non-alcoholic fatty liver disease
- Nutritional disorders, such as malnutrition and obesity
They also help children with feeding difficulties, growth concerns, and those who require tube feeding or intravenous nutrition. With their focused expertise, pediatric gastroenterologists play a vital role in supporting both the digestive health and overall well-being of children.
Common Pediatric GI Conditions
Children can experience a wide range of gastrointestinal (GI) disorders, from relatively minor discomforts to chronic diseases that affect their overall growth and development. Pediatric gastroenterologists are trained to identify and manage these conditions with care tailored to the unique needs of young patients. Below are some of the most commonly encountered pediatric GI conditions:
Functional Disorders
- Functional Abdominal Pain (FAP): Recurring stomach pain without a clear medical cause.
- Irritable Bowel Syndrome (IBS): Causes abdominal discomfort, bloating, and changes in bowel habits, such as diarrhea or constipation.
- Functional Constipation: Chronic constipation not linked to structural or biochemical abnormalities.
Inflammatory Conditions
- Inflammatory Bowel Disease (IBD): Includes Crohn’s disease and ulcerative colitis, both involving chronic inflammation of the digestive tract.
- Celiac Disease: An autoimmune disorder triggered by gluten, which damages the lining of the small intestine and impairs nutrient absorption.
Nutritional and Metabolic Disorders
- Malnutrition and Failure to Thrive: Result from inadequate intake or poor absorption of nutrients, leading to delayed growth and development.
- Obesity: Excess weight that may contribute to additional health complications in children.
- Lactose Intolerance: Difficulty digesting lactose, the sugar found in milk, often causing bloating, gas, or diarrhea.
Liver and Pancreatic Disorders
- Hepatitis: Inflammation of the liver, often caused by viral infections.
- Non-Alcoholic Fatty Liver Disease (NAFLD): Buildup of fat in the liver not linked to alcohol use, increasingly seen in children.
- Pancreatitis: Inflammation of the pancreas, which may be acute or chronic, causing pain and digestive issues.
Each of these conditions can have a significant effect on a child’s quality of life, making timely diagnosis and specialized treatment critical for healthy growth and development.
Differences from Adult Gastroenterology
Pediatric gastroenterology is distinct from adult gastroenterology in several important ways, reflecting the unique needs of children and adolescents. These differences influence how conditions are diagnosed, managed, and treated, emphasizing the value of care provided by specialists trained specifically in pediatric health.
- Anatomical and Physiological Differences
Children’s digestive systems are still developing, which can affect how gastrointestinal diseases present, progress, and respond to treatment. What may be a minor issue in an adult could have different implications in a growing child.
- Growth and Development Considerations
Gastrointestinal conditions in children can impact growth, weight gain, and overall development. Treatment plans must be carefully adjusted to support both symptom management and healthy physical development.
- Diagnostic Approaches
Pediatric gastroenterologists use age-appropriate diagnostic tools and techniques. This includes selecting tests that are both effective and minimally distressing for children of different ages.
- Communication and Care
Treating children involves more than just medical expertise—it requires the ability to communicate effectively with both young patients and their families. Pediatric specialists are trained to create a supportive environment that fosters comfort, trust, and understanding throughout the care process.
These main differences reinforce the need for specialized pediatric care, ensuring that children receive accurate diagnoses and treatment plans suited to their developmental stage and unique health needs.
Pediatric Gastroenterology Tests
To accurately diagnose GI conditions in children, pediatric gastroenterologists use a range of specialized tests tailored to young patients. Endoscopic procedures like upper endoscopy (EGD) and colonoscopy allow direct visualization of the digestive tract and enable tissue biopsy to check for inflammation, ulcers, or structural problems.
Imaging studies such as MRI, CT scans, and ultrasounds help detect internal abnormalities in organs like the liver, pancreas, or intestines. These non-invasive tests provide critical insights into structural issues that may be contributing to a child’s symptoms.
In cases involving abnormal digestive movement, motility tests are used to evaluate how well food moves through the GI tract. pH monitoring is another useful test, especially for diagnosing gastroesophageal reflux disease (GERD), by measuring acid levels in the esophagus over time.
Additional tools include stool tests to detect infections, inflammation, or nutrient absorption issues, and liver biopsy for diagnosing conditions such as hepatitis or fatty liver disease. Together, these tests support accurate diagnoses and help shape personalized treatment plans for each child’s needs.
When to See a Pediatric Gastroenterologist
If your child is experiencing ongoing digestive issues, a consultation with a pediatric gastroenterologist may be necessary to determine the cause and begin appropriate treatment. Certain symptoms are clear indicators that specialized evaluation is needed, and early referral can lead to more effective management and improved health outcomes.
Common reasons for testing include:
Persistent Abdominal Pain: Frequent or intense stomach aches that disrupt daily life may point to an underlying gastrointestinal issue that needs further investigation.
Chronic Diarrhea or Constipation: Ongoing irregularities in bowel movements can signal functional or inflammatory disorders requiring specialized care.
Vomiting: Repeated vomiting not associated with infections should be evaluated to rule out more serious digestive system concerns.
Poor Growth or Weight Gain: Inadequate growth or unexplained weight loss—also referred to as failure to thrive—may indicate nutritional deficiencies or malabsorption issues.
Blood in Stool: Visible or hidden blood in stool can suggest gastrointestinal bleeding and should be promptly assessed.
Difficulty Swallowing or Feeding: Trouble eating or swallowing may point to esophageal or motility disorders that warrant further testing.
A pediatric gastroenterologist can recommend age-appropriate diagnostic tests based on your child’s symptoms, helping to identify the root cause and begin a targeted treatment plan.
Sources.
Squires, J. E., Alonso, E. M., Ibrahim, S. H., Kasper, V., Kehar, M., Martinez, M., & Squires, R. H. (2022). North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition position paper on the diagnosis and management of pediatric acute liver failure. Journal of pediatric gastroenterology and nutrition, 74(1), 138-158.
Guandalini, S., Dhawan, A., & Branski, D. (2022). Textbook of pediatric gastroenterology, hepatology and nutrition. Springer International Publishing.
