As a parent we despair if our child does not eat well, has an abdominal pain or at newborn age regurgitates milk, has an inferior development or loses weight. It may happen that the whole family suffers from lack of sleep and fatigue owing to the infant’s painful crying at nights due to colic. These complaints often call for the medical advice of a specialist doctor. In our specialty counselling children from newborn age to the end of the teenage period receive medical attention and treatment since even adolescent age may bring unexpected problems.
What are the most frequent symptoms which make patients to see our gastroenterological counselling:
Gastroenterology interprets the diseases of the stomach and the intestinal system, the liver and the pancreas. Origins of the aforesaid ailments are somatic and psychic. A psychical reason happens to create anxiety in the child which may result in dietetic disorders but it may also be possible that cause of the disease derives from another organ or organ system. In that case the complementary medical attention of specialists may be necessary. Even if this happens we could assist our patients as at our clinic specialist doctors of the associated branches of medicine (endocrinology, cardiology, psychology, and psychiatry) are also available.
- infant age: pain in the stomach, inferior weight gain, bloody stool, regurgitating milk, eczema, frequent and hectic crying
- childhood: sustained diarrhea, pain in the stomach, obstipation, bloody stool, bad breath, acid indigestion, eczema, eating problems, unsatisfactory weight gain
Clinical aspects which we care for with top priority:
- food allergy – first symptoms may appear in infancy but they may occur later as well; symptoms are: diarrhea, vomiting, distention, bloody stool, hives, dry skin, eczema and on rare occasions running nose and sneezing
- reflux disease – assumable this is in the background if for example the baby hiccups many times at length after feedings; in this case the coming back up of the content of the stomach irritates and/or impairs the mucous membrane of the gullet and may cause inflammation and burn. It is typical of the childhood reflux that symptoms are not originating from the digestive track but they may appear in different forms. With medicinal or non-medicinal treatment this disease could be well treated.
- slow weight gain
- coeliac disease (wheat hypersensivity) – this ailment constitutes an inflammatory status which is generated by the gluten hypersensivity of the organism; it may provoke the lesions of different extent of the intestinal villi of the small bowels and may cause intestinal malabsorption
- lactose and/or fructose decay disorder
lactose intolerance – due to the absence of lactase enzyme or its improper function the organism cannot process lactose; most characteristic symptoms of lactose intolerance are distention, excess wind and stool, diarrhea, abdominal cramps.
Clinical aspects relating to older children:
- inflammatory bowel diseases (colitis ulcerosa, Crohn’s disease)
- IBS (irritable bowel syndrome) – main symptoms are recurring abdominal pain, diarrhea, obstipation, excess wind; its triggering cause has not been identified yet however stress may play a part in the development of this disease
- liver disorders – these problems are the most frequent ones which may develop in childhood too; symptoms are similar to the characteristics of influenza like shivering, head ache, limited appetite, sometimes diarrhea, abdominal disorders, jaundice.
We perform the following routine examinations:
- laboratory tests: coeliac serology, specific IgE examination for food allergy
- H2 exhalation test (lactose and/or fructose decay disorder)
- skin prick test (examination of different allergies)
Dietary counselling and stress test of milk protein and egg tolerance under medical observation (without phlebotomy) are also available.
Selective examinations and enough time for counselling
One of the most important aspects of the counselling of pediatric gastroenterology is the interactive communication – with the parents or with the child reaching the age of communication abilities. Although this part of the examination seems to be just a simple chat, in fact it is a purposeful process. In most cases it provides the answers for the questions or it reveals the direction which the specialist must follow to establish the diagnosis. In a word the doctor has to devote enough time for the patient, the family and the examinations.
Examinations – just which are really needed
We make efforts to execute examinations only with the lowest possible stress and inconvenience but possibly with the highest gain of information. Owing to the peculiarity of the clinical aspects and symptoms of gastroenterology in most cases the medical check-up needs more visits to the specialist. In our specialty clinic we receive patients and their parents from newborn to young adulthood age. During the visits we endeavour to create feeling and conditions which could relieve distress, fear, distrust and we guarantee discretion and secrecy all the time.
It often happens that we cannot identify any organic disease in the background of the symptoms. In these cases we consider the recognition of the background of the somatization disorders important and it is also important not to leave the family alone with this complaint. We seek to offer the associated medicine’s assistance (therapist for eating disorders, psychologist, ADHD, surveying of learning disorders) in order to solve the problem. In case of problems appearing on the check-up and relating to the frontiers of the associated medicine we have the possibility to ask for a direct conference of doctors and assistance (dietitian, psychologist) or as already detailed above to extend the examination (endocrinology, cardiology).
Since complaints are rarely specific, objective assessment of the symptoms may come up against a difficulty due to the specialties of childhood. Owing to the utmost diversity of symptoms, in the course of children’s examinations, there could be room for the so-called holistic approach in which the whole person is focused on.