Pediatric gastroenterology, hepatology and nutrition

• Food intolerances: for example, lactose intolerance, gluten intolerance, intolerance to FODMAPs, etc.
• Food allergies: for example, cow's milk protein allergy.
• Celiac disease.
• Food and nutrition problems requiring dietary intake and/or support through enteral nutrition via nasogastric tube or gastrostomy and/or parenteral nutrition.
• Chronic inflammatory bowel disease: Crohn's disease, (chronic intestinal inflammation that can affect the entire digestive tract), ulcerative colitis (chronic disease affecting the large intestine).
• Gastroesophageal reflux: a disorder characterized by the rise of acidic stomach contents into the esophagus.
• Disorders of intestinal motility.
• H. pylori gastritis.
• Eosinophilic esophagitis and eosinophilic gastroenteropathies: an inflammatory condition in which the wall of the esophagus and/or other parts of the intestine becomes filled with a huge amount of eosinophils, a type of white blood cell.
• Constipation.
• Functional gastrointestinal disorders: for example, irritable bowel syndrome, functional dyspepsia, abdominal migraine, cyclic vomiting syndrome, etc.
• Diseases of the liver, biliary tract, and pancreas in children.

Diagnosis

The diagnostic techniques include:

• 24-hourPh-metry.
• Genetics of ThioPurinMethylTransferase (TPMT) and thiopurine metabolites.
• Antibody assay and blood levels of biologics and biosimilars.
• Radiological diagnostics (traditional radiography with or without contrast medium. esophago-gastro-duodenal transit, ultrasound, abdominal MRI, entero MRI).
• Digestive endoscopy (esophago-gastro-duodenoscopy, ileo-colonoscopy, recto-sigmoidoscopy).
• Enteroscopy with videocapsule.
• Percutaneous liverbiopsy .

Treatments

Therapeutic interventions include:

• Targeted medical therapy, with emphasis on administration of biological therapy in day hospital or at home.
• Artificial nutrition: enteral and parenteral in inpatient and home care.
• Dietary care of different diseases.