Paediatric gastroenterologist plays a crucial role in the diagnosis and management of digestive disorders in children. With the rise in the incidence of gastrointestinal conditions among young individuals, specialised care provided by paediatric gastroenterologists becomes vital in ensuring optimal digestive health for children. In this blog, we'll delve into the significance of paediatric gastroenterology, with a focus on common conditions such as inflammatory bowel disease (IBD), Crohn's disease, ulcerative colitis, and irritable bowel syndrome (IBS).

What Is Paediatric Gastroenterology?

Paediatric gastroenterology is a branch of medicine dedicated to the study and treatment of gastrointestinal conditions in children. It encompasses a multidisciplinary approach involving paediatricians, dieticians, surgeons, and psychologists to provide comprehensive care for young patients. The field focuses on diagnosing and managing various digestive disorders, ensuring children receive specialised attention for their specific needs.

Digestive disorders in kids, like IBD, Crohn's disease, ulcerative colitis, and IBS, have recently become more prevalent. These conditions may significantly impact the affected children’s physical, emotional, and social well-being. Hence, early detection and specialised care are essential to avert complications, encourage healthy growth, and improve overall quality of life.

What Do Paediatric Gastroenterologists Treat?

Here are some conditions that paediatric gastroenterologists treat:

1. Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease is a group of persistent inflammatory conditions that affect the gastrointestinal tract. Crohn's disease and ulcerative colitis are the two main types of IBD. While ulcerative colitis primarily affects the colon and rectum, Crohn's disease can harm any area of the digestive tract. Dеspіte their differences, both illnesses share symptoms like gastrointestinal discomfort, diarrhoea, fatigue, and weight loss.

How Is It Treated?

Diagnosing IBD in children involves a combination of medical history, physical examination, imaging tests, endoscopy, and biopsies. Paediatric gastroenterologists play a crucial role in accurately diagnosing the condition and determining its severity. Treatment approaches for IBD are individualised based on the child's age, disease severity, and specific needs. 

These may include medications to reduce inflammation, control symptoms, and induce remission. Nutritional therapy, such as exclusive enteral nutrition, can also be utilised. In severe cases, surgical interventions may be necessary.

Paediatric gastroenterologists coordinate the comprehensive care of children with IBD, ensuring proper medication management, and nutritional support, and addressing the psychosocial aspects of living with a chronic condition.

2. Crohn's Disease

It is a chronic inflammatory disease that may affect any portion of the digestive tract. It is characterised by periodical active inflammation followed by periodical remission. Common symptoms are: 

• Abdominal pain

• Diarrhoea

• Bloody stools

• Fatigue

• Poor growth

Crohn's disease can also have extra intestinal manifestations, affecting joints, skin, eyes, and liver.

How Do Paediatric Gastroenterologists Deal With Crohn’s Disease?

Paediatric gastroenterologists play a pivotal role in the management of Crohn's disease in children. They collaborate with other healthcare providers to establish an accurate diagnosis and monitor disease progression. Treatment strategies are tailored to each child's specific needs, aiming to achieve and maintain disease control and remission. 

Medications, such as anti-inflammatory drugs, immunomodulators, and biologics, are commonly used. Nutritional support is essential to address growth impairments and nutritional deficiencies. Paediatric gastroenterologists work closely with dieticians to develop dietary plans that optimise nutrition while managing symptoms. 

They also address the psychological impact of the disease, providing resources and support to help children and their parents cope with the difficulties of living with Crohn's disease.

3. Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory condition that primarily affects the colon and rectum. It is characterised by periods of flare-ups and remission. Common symptoms include: 

• Bloody diarrhoea

• Abdominal pain

• Urgency to defecate

• Rectal bleeding
  

Children with ulcerative colitis may experience growth delays, nutritional deficiencies, and psychosocial challenges due to the effects of the disease on their day-to-day life.

How Do Paediatric Gastroenterologists Manage Ulcerative Colitis?

Paediatric gastroenterologists employ various diagnostic techniques, including clinical assessments, laboratory tests, endoscopy, and imaging, to diagnose ulcerative colitis in children. They create personalised treatment plans based on disease severity and the child's unique needs. Medications, such as anti-inflammatory drugs and immunosuppressants, are commonly used to induce and maintain remission. 

Paediatric gastroenterologists monitor the child's growth, nutritional status, and response to treatment through regular follow-up visits. Nutritional support is crucial to ensure adequate growth and address any deficiencies. In severe cases, surgery might also be necessary, and paediatric gastroenterologists work closely with paediatric surgeons to provide optimal surgical care.

4. Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome is a functional gastrointestinal disorder characterised by recurring abdominal pain and changes in bowel habits. It is a common condition in children. It can show with symptoms such as:

• Abdominal discomfort

• Bloating

• Diarrhoea

• Constipation

Unlike IBD, IBS does not cause inflammation or structural abnormalities in the digestive tract.

How Do Paediatric Gastroenterologists Treat Irritable Bowel Syndrome?

Diagnosing IBS in children involves a symptom-based approach, ruling out other potential causes. Paediatric gastroenterologists work closely with children and their families to identify triggers and develop individualised management plans. Dietary modifications may be recommended, such as eliminating certain foods or following a low-FODMAP diet.

The treatment plan may also include stress management techniques, counselling, and medications. Paediatric gastroenterologists provide ongoing support, education, and resources to empower children and their families in managing IBS symptoms and improving their quality of life.

Wrapping Up

Paediatric gastroenterologists ensure that children receive comprehensive and tailored treatment plans by diagnosing and managing conditions such as IBD (including Crohn's disease and ulcerative colitis) and IBS. 

Paediatric gastroenterologists aim to optimise children's digestive health and enhance their overall well-being. If your child experiences digestive health concerns, consult an experienced paediatric gastroenterologist to provide the best possible care for their unique needs!

FAQs

1. What does a paediatric gastroenterologist do?

A paediatric gastroenterologist specialises in diagnosing and treating digestive system, liver, and nutritional issues in children, including conditions like acid reflux, celiac disease, and inflammatory bowel diseases.

2. When should I take my child to a paediatric gastroenterologist?

You should consider seeing a paediatric gastroenterologist if your child has persistent stomach pain, vomiting, diarrhoea, constipation, poor weight gain, or suspected food allergies.

3. Do paediatric gastroenterologists perform endoscopies?

Yes, they perform procedures like endoscopies and colonoscopies to diagnose and sometimes treat gastrointestinal issues in children.

4. Can a paediatric gastroenterologist help with feeding difficulties?

Absolutely! They address feeding challenges, swallowing issues, and failure to thrive, often working with a multidisciplinary team.

5. Do paediatric gastroenterologists treat food allergies?

Yes, they often diagnose and manage food allergies and intolerances that affect the gastrointestinal system, such as lactose or gluten intolerance.

Citations

Bellini, M., Tonarelli, S., Nagy, A., Pancetti, A., Costa, F., Ricchiuti, A., De Bortoli, N., Mosca, M., Marchi, S., & Rossi, A. (2020). Low FODMAP diet: Evidence, doubts, and hopes. Nutrients, 12(1), 148. https://doi.org/10.3390/nu12010148

Devanarayana, N. M., & Rajindrajith, S. (2018). Irritable bowel syndrome in children: Current knowledge, challenges and opportunities. World Journal of Gastroenterology, 24(21), 2211–2235. https://doi.org/10.3748/wjg.v24.i21.2211

Mackner, L. M., Greenley, R. N., Szigethy, E., Herzer, M., Deer, K., & Hommel, K. A. (2013). Psychosocial issues in paediatric inflammatory bowel disease. Journal of Paediatric Gastroenterology and Nutrition, 56(4), 449–458. https://doi.org/10.1097/mpg.0b013e3182841263

Vivier, H., Ross, E. J., & Cassisi, J. E. (2020). Classification of gastrointestinal symptom patterns in young adults. BMC Gastroenterology, 20(1). https://doi.org/10.1186/s12876-020-01478-7