Gastroenterology relates to the treatment of conditions and diseases of the digestive system. Anywhere in the digestive system can be affected – from the oesophagus and stomach to the small intestine, large intestine (colon), rectum, liver, gallbladder and pancreas.
The paediatric gastroenterology department at The Portland Hospital provides consultations and treatments for children with a wide range of gastrointestinal diseases. The hospital has a dedicated multidisciplinary feeding clinic for children of all ages who experience difficulties with feeding and nutrition.
Gastroenterological disorders include:
- Gastro-oesophageal reflux – a common disorder in children where stomach acid travels back up the oesophagus causing symptoms such as heartburn, nausea and a feeling of regurgitation. It is common in infants and also in older children. There may also be an allergic component to this problem, often to dairy protein.
- Peptic-ulcers – sores on the lining of the stomach or start of the intestine, commonly caused by the Helicobacter pylori bacteria.
- Giardia – a type of gastro-enteritis, or inflammation of the intestines, caused by an infection with the parasite Giardia lamblia.
- Coeliac disease – an inflammatory condition of the small intestine caused by a child's intolerance to gluten, which is in cereals. Symptoms include diarrhoea, constipation, weight loss, failure to gain weight, anaemia, fatigue and mouth ulcers, and is diagnosed by an endoscopy. A life-long gluten free diet is needed.
- Inflammatory bowel disease (Crohn's disease and Ulcerative Colitis) – inflammation of the gastro-intestinal tract in Crohn’s disease can be anywhere from the mouth to the bottom. With Ulcerative Colitis it usually just involves the colon or the large bowel.
- Child constipation – a significant problem in childhood which needs treatment that is effective and age appropriate. Occasionally it can be caused by underlying conditions like a nerve supply problem to the bottom or anus which is called Hirschsprung’s disease and is diagnosed by biopsy. Very occasionally low thyroid function and calcium disturbance can cause constipation but this is unusual.
- Recurrent abdominal pain – a common condition which occurs in all age groups and has many different origins.
Other gastroenterological conditions treated include feeding disorders, faltering growth, allergic gut problems, toddler's diarrhoea, lactose intolerance, sucrose intolerance, gut infections, recurrent abdominal pain, nutritional problems, gut blood loss and anaemia, bacterial overgrowth, anal fissures, infant colic and common liver and pancreatic problems.
Children experiencing gastro-intestinal problems may need a number of investigations. These include blood tests, breath tests for sugar intolerances, faeces tests and sometimes children will need an endoscopy to diagnose the condition. This involves a long, flexible tube which takes video and is inserted via the mouth or anus. Tiny pieces of tissue, called biopsies, are taken during this procedure which are harmless and can give much more information than just a visual assessment.
Treatments offered at the Portland Hospital include:
- Upper GI endoscopy – a test to look at the oesophagus, stomach and the first part of the intestine.
- Ileo-colonoscopy – a test to look at the bowel and colon.
- Percutaneous Endoscopic Gastrostomy – where a tube is inserted into the stomach through the abdominal wall to help with feeding.
- Polypectomy – removal of benign growths usually from the colon.
- Oesophageal Dilatation – a technique used to stretch or open a blocked portion of the oesophagus.
- Wireless Capsule Endoscopy – a capsule containing a small camera which is swallowed, allowing the camera to take pictures of the digestive system.
- Endoscopic anti-reflux procedures – these can be used instead of surgery to help with reflux.
- Enteroscopy - a technique to look at as much of the small bowel as possible by endoscopy, again to avoid an operation.
- Video-fluoroscopy – an X-ray that looks at the way swallowing works.
- Abdominal ultrasound – a scan to look at structures such as the pancreas, the gall bladder, the kidneys and liver.
- CT and MRI scans – scans to look at the bowel, liver and pancreas.
- Barium swallows and meals – a less commonly used procedure now to look at the bowel, but still offered.
Paediatric Consultant Gastroenterologists
Dr Muftah Eltumi
Dr Mark Furman
Dr David Rawat
Dr Neil Shah
Dr Nikhil Thapar
Dr Mike Thomson
For more information or to arrange an appointment please contact our Children's Enquiry Line on 020 7390 8020.