Our Services

Stanford Medicine Children's Health - Pediatric Gastroenterology offers a comprehensive evaluation and state of the art medical care to infants, children and young adults. We provide diagnostic services and medical management for patients with diseases of the esophagus, stomach, small intestine, colon, liver, pancreas, and nutritional disorders in newborns, children and young adults.

We care for common and complex gastrointestinal disorders of children. Our range of expertise includes, but it is not limited to, evaluation of growth failure, malnutrition, vomiting, chronic diarrhea, constipation, stool soiling, abdominal pain, rectal bleeding, Celiac disease, food allergy, Crohn's disease, colitis, ulcerative colitis, pancreatitis, eosinophilic esophagitis, and hepatitis (elevated liver tests). We also manage children born with abnormalities affecting the gastrointestinal tract.

Common diseases

Consultation services

Outpatient consultation

We provide consultation for patients 21 years and younger. Because the decision to perform procedures requires a comprehensive initial evaluation, please note that no procedures are performed during your initial consultation.

Inpatient consultation 

We are available for consultation for children hospitalized at our affiliated hospitals. If you believe your child requires a consultation from one of our gastroenterologists, please discuss this with your child’s provider.

Nutritional consultation 

Patients can have a nutritional consultation with a Registered Dietician that specializes in pediatrics.

Procedures

Upper endoscopy 

This is the most common procedure. A thin flexible tube with a camera is inserted in the mouth to see the esophagus, stomach, and first part of the small intestine. The test is used to evaluate for acid reflux, ulcers, eosinophilic esophagitis, celiac disease, poor growth, and inflammatory bowel disease. Small pieces of tissue, about the size of a pinhead, are usually taken for testing. This test is done with general anesthesia, usually as an outpatient.

Colonoscopy 

A flexible tube with a camera is used to look into the last part of the intestines (colon and terminal ileum). The test helps to evaluate polyps, inflammatory bowel disease, and other causes of gastrointestinal bleeding. Small tissue samples, the size of a pinhead, are taken. Polyps, which are growths of tissue lining the intestines, may also be removed. The test is done with general anesthesia, usually as an outpatient.

Percutaneous liver biopsy

A thin needle is inserted through the skin into the liver to obtain a small sample of tissue from the liver. Liver biopsies may be needed to evaluate jaundice (yellowing of the skin), abnormal liver function tests, or an enlarged liver. This test is done with light sedation or general anesthesia, and may require overnight observation.

Esophageal pH probe

This is a 24-hour test to measure the frequency that acid in the stomach goes up into the esophagus. It is used to determine the effectiveness of antacids, to determine severity of gastroesophageal reflux, and to find out if certain symptoms such as cough, choking, or hoarse voice are related to gastroesophageal reflux. Most patients may complete the test at home after the probe is placed. They return the next day to have the probe removed.

Combined Impedance pH probe

This test measures how frequently acid and nonacid stomach contents go up into the esophagus. It can also show how high up refluxed stomach contents may go. It can also help show if certain symptoms such as cough, choking, or hoarse voice are related to gastroesophageal reflux. Most patients may complete the test at home after the probe is placed. They return the next day to have the probe removed.

Breath testing

Hydrogen and methane in exhaled breath are measured to evaluate for lactose intolerance, intolerance of other sugars, or for intestinal bacterial overgrowth. It helps evaluate persons with bloating, diarrhea, or stomach pain.

Esophageal motility study (esophageal manometry)

This test measures if the esophagus muscle has normal pressures at rest and during swallowing. It is indicated for children with difficulty swallowing, chest pain, or to determine if certain medicines or surgeries are working.

Anorectal motility study (anorectal manometry)

This tests measures pressures in the rectum (last part of the colon) and anus. It can help find reasons for chronic constipation or fecal soiling, to evaluate injured nerves or muscles, and confirm suspected Hirschsprung's disease.

Percutaneous endoscopic gastrostomy (PEG)

Children who cannot take enough calories by mouth or who have special nutritional needs may require a feeding tube. A PEG is one way to place afeeding tube from the skin into the stomach.

Acupuncture

Acupuncture involves the insertion of tiny needles into the skin to provide relief for conditions including abdominal pain, IBS, and anxiety, and as a treatment for disease management. Acupuncture is a practice which originated in traditional Chinese medicine, and aims to improve energy flow between points in the body. Acupuncture is performed without any anesthesia and most children experience little to no pain during the procedure. Matthew Goldman, MD, is certified to perform these acupuncture services at our clinic and has successfully introduced this innovative technique for several years in pediatric patients with GI conditions.

Video capsule endoscopy

Video Capsule Endoscopy (VCE) is widely recognized as an effective and noninvasive option to assess a patient’s small intestine, a part of the body that cannot be seen by upper endoscopy or colonoscopy.  A camera sits inside of a vitamin-sized capsule that is either swallowed by the patient or placed into the GI tract during an endoscopy procedure under anesthesia for those that cannot swallow the capsule. This capsule passes naturally through the digestive tract while transmitting video images to a data recorder, which are then downloaded to a computer and reviewed by a physician. This procedure helps to identify causes of unexplained gastrointestinal bleeding, inflammatory bowel disease, ulcers, tumors, and Crohn’s disease, and helps to evaluate chronic unexplained abdominal pain, polyposis syndrome, and unexplained anemia.