Department of Gastroenterology. Pediatric gastroenterologist appointment When to see a specialist

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Morozov Children's Hospital Gastroenterology Department, a structural subdivision of the Moscow Children's Clinical Hospital.

For the purposes of the hospital, a complete examination of patients with gastroenterological diseases, including highly qualified medical care using high technologies, including in relation to intestinal inflammatory diseases, such as ulcerative colitis, Korn's disease.
The Morozov Hospital Gastroenterology Department has 20 beds in the inpatient part, including an additional 10 day regimen, and special highly comfortable wards.
Gastroenterology Department, at the same time, the only profiling center in Moscow for children with IBD. This department also provides modern high-quality primary medical care, including examination and treatment methods. In addition, there is a follow-up observation for children with IBD. To date, the gastroenterological department provides services for all children in the city of Moscow, whose age starts from the 1st month of infancy and reaches full adulthood (18 years). This applies to children with inflammatory bowel disease (IBD). Only all innovative methods of examination and obtaining diagnostic data are used in the department. Such as laboratory examinations (including biochemical, serological, microbiological examination methods, determination of calprotectin index), endoscopic examinations (esophagogastroduodenoscopy and rectosigmoscopy, colonoscopy, video capsule endoscopy), histological examinations, ultrasound, X-ray, and, electron-computed tomography , both standard MRI and MRI cholangiography performed in the gastroenterology department of the Morozov Children's Hospital.
The Gastroenterology Department of the Morozov Hospital is also the leading institution in the Russian Federation regarding the diagnosis and treatment of pediatric IBD.
Since 2007, on the basis of the gastroenterology department, the first center for therapeutic anticytokinia for children with IBD has been formed. As indicated in the order of the Moscow Department of Health dated April 29, 2009 No. No. 458, Morozov Hospital today is responsible for the provision of medicines and the competent use of the effective, expensive and innovative drug Remicade (infliximab in other words). In the gastroenterological department, prescriptions for medicines necessary for patients are issued, including special conditions for the safe and effective administration of the drug.

Tasks of the anticytokine center;
Qualified and timely assistance to sick children with established IBD, such as ulcerative colitis, Crohn's disease. Including the use and introduction of innovative drugs called "biological agents".
Observational activities for patients with inflammatory bowel diseases: electronic diagnostics of the condition of patients, their immunological status in accordance with the developed innovative standards of treatment and assessment of the quality of the treatment.
Consultative and diagnostic work in relation to the complex therapeutic activities of severe, resistant to conventional therapy, children with inflammatory bowel diseases, an integral part of the gastroenterological department of the Morozov Children's Hospital.
Increasing the comfort and quality of life of patients with IBD. Distribution of biological therapy to residents of Moscow.

Functional diseases of the colon (constipation, incontinence, irritable bowel syndrome)
In the gastroenterology department, all innovative examination methods are produced for the diagnosis of the differential type in relation to the large intestine. Such as clinical and laboratory type, ultrasound, including ultrasound of the colon, X-ray type of examinations, together with defecography, endoscopic type of examination, staged biopsy of the laparoscopic type, examination of the morphology of the colon mucosa, examination of histochemical types (regarding acetylcholinesterase), additional functional examination methods ( such as the study of the obturator apparatus of the rectum, as well as motirika, relative to the colon).
In addition, all types of constipation treatment are performed, including innovative methods in pharmacotherapy, in physiotherapy treatments, as well as reflexology, recreational physical education, including massage procedures and correctional work on psychological status, biofeedback therapeutic work.
Malabsorption Syndrome
In the gastroenterological department, a full range of clinical and laboratory, instrumental and morphological examinations is also performed, including esophagogastroduodenoscopy with a biopsy sample c/3 of the stomach and jejunum. Also, urgent diagnosis of the state of the gastric mucosa, including the colon (macroanatomical assessment of biopsy material). A specific immunology test for celiac disease, examination of the immune system status, assessments of nutrition and physical development, digestive function, sweat test, as well as detection of predisposition to celiac disease by genes.

Pathology of the hepatopancreatobiliary system
During the activities of the department, a comprehensive study (MRI, CT) is carried out and children who have diseases in the digestive organs are treated: various pathologies of the hepatopancreatobiliary system, such as pancreatitis, gallstone disease, Gilbert's syndrome.

Pathology of the upper gastrointestinal tract
The Department of Gastroenterology has accumulated considerable knowledge in the conduct of medical processes in relation to patients with pathology of the gastroenterological type. Such as esophagitis, gastroesophageal reflux disease, Barrett's esophagus, gastric and duodenal ulcers, gastroduodenitis. Having all the necessary examination methods in its arsenal, a competent diagnosis is made and an immediate start of modern pathogenetic therapy is made.
Examination methods: FEGDS, ultrasound, daily pH monitoring, determination of the presence of Helicobacter pylori in various ways, radiological, immunological, bacteriological and morphological methods of examination.
Taking into account that the MDGKB is a medical institution of a multidisciplinary pediatric nature, children undergoing a treatment period in the hospital, if necessary, can consult with a number of qualified specialists. For example: surgeon, cardiologist, pulmonologist, neurologist, psychologist and others.
The department of gastroenterology of the Morozov Children's Hospital is today the practical basis for the pediatric department with a referral to pediatric surgery at the Maimonides State Clinical Hospital. Propaedeutics of childhood diseases of SBEI HPE Russian National Research Medical University named after N.I. Pirogov, Central Research Institute of Epidemiology, closely cooperate with this Department of Pediatric Surgery of the Moscow State Medical University and the State Research Center of Coloproctology of the Ministry of Health of the Russian Federation. Every week, everyday life is held with the participation of professors and various specialists from these departments.
Collegiat of the department of gastroenterology consistently takes part in both foreign and all-Russian and international congresses. Every year there are conferences regarding children's IBD. These conferences are called "Kanshi Readings", in which the best specialists in this field participate.
Employees of the gastroenterological department of the Morozov hospital take an active part in the activities of the Russian Society for the study of inflammatory bowel diseases (Head of the Department - Professor Khalif I.L., State Scientific Center for Coloproctology (Director - Professor Yu.A. Shelygin)). With the help of their direct participation, the fundamental standards for the diagnostic treatment of children of all ages who have problems with ulcerative colitis, Korn's disease, etc. have been formed. The final work today is the main document for the competent work of doctors throughout Russia.

Every parent, at least subconsciously, is always afraid that his child will get sick. And this really happens sometimes - kids get sick. However, not always in such cases they need the help of a pediatrician or an otorhinolaryngologist. Sometimes you have to turn to a doctor like a gastroenterologist. What kind of specialist, what does he treat, and where to find the best pediatric gastroenterologist?

Who is a gastroenterologist

First of all, it is worth clarifying what kind of doctor such a gastroenterologist is and what ailments he treats. After all, not everyone is strong in medical terminology. So, a gastroenterologist (children's or adult - it doesn't matter) is a specialist who treats the organs of the gastrointestinal tract. In addition, he is also engaged in the prevention of various kinds of diseases of this system of the body. The most common sore among them, but by no means the most dangerous, is, perhaps, gastritis. The word "gastroenterologist" in Greek means "womb" (gaster), "intestine" (enteron) and "teaching" (logos). Hence it turns out that this doctor just treats such organs as the intestines, gallbladder, esophagus, liver, duodenum, and the like.

What diseases can be treated

As mentioned above, probably the most common reason for treatment (at least for a pediatric gastroenterologist) is gastritis. This is an inflammation of the lining of the stomach, usually due to improper diet and lifestyle in general. Also, the reason to come to the clinic for an appointment with this doctor may be:

stomach ulcer;
hepatitis of various types;
dysbacteriosis;
pancreatitis (inflammation of the pancreas);
stones in the urinary and / or gallbladder;
a symptom of the so-called acute abdomen (that is, sharp and acute pain), which includes appendicitis, peritonitis and many other diseases.

When you don't have to endure

It's no secret that the mentality of a Russian person is such that he does not like to go to doctors. It would be better to endure to the last, and go to a specialist only if it becomes completely unbearable. Still, it is worth overcoming yourself and not waiting until you “squeeze”, but go to the clinic yourself or call a doctor at home. If this advice is relevant for adults, then it is all the more important when it comes to the health of the child.

So, in what cases is it necessary to contact a gastroenterologist?

The child complains of pain in the abdomen, which does not go away for some time and prevents him from leading a normal life.
Decreased appetite or disappeared altogether, decreased weight.
In addition to pain, the child often has nausea and/or vomiting.
His stomach hurts not only during the day, but also at night, preventing him from sleeping normally.
The child has a history of any (any) disease of the gastrointestinal tract.

At the appointment with a specialist

Most often, it is impossible to get to a gastroenterologist without a referral from a pediatrician, therefore, you will first have to visit this doctor. You should have a medical card and the results of the tests you have passed with you, if they are, of course, available. Important: if a white, yellow or any other coating appears on the tongue, you do not need to remove it before visiting the doctor. Inspection of the tongue is an indispensable condition for the examination process, as it helps the gastroenterologist to get a more complete and clear picture of what is happening.

Before rushing to use the services of a pediatric gastroenterologist in the clinic's hospital at the slightest occurrence of complaints in a child, you should familiarize yourself with the information below, which, by the way, is a recommendation of just the same specialized specialists.

Firstly, if the baby has a stomach ache and the pain is not sharp and not sharp, then there is no need to panic and assume the worst. First, you should call the local doctor from your clinic, he must examine the child and only then decide what to do next. However, in the event that the pain arose suddenly, "out of nowhere", it is strong, sharp, then there is no need to wait, you need to immediately call an ambulance.

Another tip is about nutrition. If the child had stomach problems before and he was prescribed a diet, you must strictly follow it. In the case of a deviation from the regimen and the use of forbidden foods, one should not be surprised that the child's chronic disease has again become aggravated.

Very often, parents with tiny children, babies up to a year old, sign up for a consultation with a pediatric gastroenterologist. Digestive disorders in such crumbs, as a rule, are caused by the same malnutrition. The main food for children of this age should remain milk - mother's or a mixture, it does not matter. Parents, trying to introduce complementary foods as soon as possible, begin to feed him with something for which the baby's ventricle is not yet ready. Therefore, do not force things. It is necessary to strictly follow the recommendations of the pediatrician and remember that everything has its time. Then an appointment with a pediatric gastroenterologist will not be needed later.

Where to go

If such a specialist is still needed, where to run? Where to find a good doctor? Where does a pediatric gastroenterologist take in the capital? Indeed, in Moscow there are an extremely large number of all kinds of clinics, it is just right to get confused. Below we list at least some of them (which patients respond well to) with an indispensable indication of the cost of services.

So, the Best Clinics medical center, which is on Nizhnyaya Krasnoselskaya Street, is very famous among the residents of the metropolitan metropolis. The provision of assistance in the field of pediatric gastroenterology varies there within two thousand rubles (plus / minus one to two hundred rubles). No less popular is the Miracle Doctor family clinic near the Ilyich Square metro station, and the cost of admission there, although not much, is cheaper - from 1600 to 1800 rubles. There is a center "K + 31" on Lobachevsky Street, where a pediatric gastroenterologist conducts an appointment for 2,800 rubles. In the 2nd Tverskoy-Yamsky Lane there is a very expensive, but, judging by the reviews, a very good center of OAO Medicina, where you will have to pay 4,300 rubles for an appointment with such a specialist.

Depending on the service, the price in the Family Clinic near the Kashirskaya metro station also fluctuates: the minimum is 1900, the maximum is 3800 rubles. And a pediatric gastroenterologist at the SM-Doctor diagnostic center on Priorova Street will be able to help for 1800-2350 rubles (depending on the type of assistance needed). By the way, the same clinic is located on Kibalchicha Street. The cheapest appointment is in the network of family clinics "Dobromed" - about 1600 rubles.

Specialists

A good doctor is always doubly valued, and a good pediatric gastroenterologist is worth its weight in gold. That is why it is so important to know the names of these specialists. Of course, you can’t list all the competent doctors of this profile in multimillion-dollar Moscow, but at least a few can be named.

Alfiya Aminova

In several places at once (for example, on Kashirskoye Highway), Alfiya Aminova, a doctor of sciences, an employee of one of the medical institutes, a specialist in pediatric gastroenterology and pediatrics, receives patients, who has received many grateful reviews from the patients treated by her. Everyone notes not only the high professionalism of this doctor, but also her friendliness to both parents and young patients. The doctor is competent, polite, pleasant, answers essentially all the questions, gives recommendations. And most importantly, he knows how to communicate with children. For all these and many other qualities, the pediatric gastroenterologist Aminova deserves to be on the list of the best specialists in the capital. The price for the services rendered by her is within two and a half thousand rubles.

Ludmila Pugacheva

A little less (from 1800 to 2350 rubles) is taken by another pediatric gastroenterologist in Moscow. This is Lyudmila Pugacheva, who works in the clinic at Priorov. After graduating from the Krasnoyarsk Medical Institute with a degree in pediatrics, she was later certified as a doctor of the highest qualification category and underwent retraining in two specialties at once: endoscopy and gastroenterology. She can be consulted for both treatment and diagnosis of various diseases of the digestive system, including endoscopic examination of the stomach. A significant advantage of the doctor Pugacheva is that she works with children of absolutely all ages, including newborn babies, who often suffer from digestive disorders. In the ranking of pediatric gastroenterologists, Pugacheva always occupies a leading position, and reviews about her are almost completely positive.

Sergei Kholodov

Sergei Kholodov, a pediatric gastroenterologist, works on Vorotynskaya Street and Kashirskoye Highway. He is a doctor of the highest qualification category and part-time endoscopist. Kholodov S. has been working in this field for twenty years. This specialist differs from others in that he can work with overweight patients using a unique technique. Kholodov accepts both children and adults with gastroenterological problems, and in addition, you can come to him for endoscopic examination.

People speak very positively about this specialist. They write that he gives the necessary recommendations, speaks informatively and to the point, is pleasant to talk to, and carries out all procedures deftly and painlessly. The main thing that parents note is his ability to find contact with a small patient, including an obstinate teenager. For his appointment, this pediatric gastroenterologist in Moscow takes two thousand rubles.

Diana Shatveryan

Diana Shatveryan works in a clinic near Ilyich Square, whose services will cost patients 1,800 rubles. Endoscopist and gastroenterologist Shatveryan is also a candidate of medical sciences. She easily performs endoscopic interventions of any kind, including stopping gastric bleeding. This pediatric gastroenterologist also works with adults, and the list of diagnostic studies that Dr. Shatveryan can perform is incredibly extensive. There are no bad reviews about this specialist, and among the positive ones there are words about sensitivity, goodwill, attentiveness to his patients.

Elena Tomilina

In the same clinic as Shatveryan, another good pediatric gastroenterologist, Elena Tomilina, is receiving. She defended her PhD, received additional specialization as an endoscopist, works with both small and adult patients. They, in turn, do not spare good words addressed to their doctor, noticing in the reviews how competent and competent a specialist is, who understands not only his field, but also related ones, and can give really worthwhile recommendations, and will also explain all those of interest in a popular way. and incomprehensible moments. And the optimism and sociability of Dr. Tomilina make her "their own person" in the eyes of the children. Services in the field of pediatric gastroenterology provided by this specialist are slightly more expensive than the previous appointment - two and a half thousand rubles.

Anatoly Matyukhin

Anatoly Matyukhin is working on Yaroslavskaya Street, not far from VDNKh. He has not been working for so long, but nevertheless he has already managed to win the trust and respect of patients and colleagues. Dr. Matyukhin is a member of the Russian Gastroenterological Association, lectures on gastroenterology, and writes scientific papers. He is actively involved in the diagnosis and treatment of such unpleasant phenomena as ulcers, various problems of the digestive system, colitis, as well as Crohn's disease (a disease that most often affects the small and / or large intestine, although any other organ of the digestive system can suffer from it). For his services in the field of pediatric gastroenterology, Matyukhin takes from 1800 to 2350 rubles. But this price is justified: patients remain, if not delighted, then at least have very favorable impressions of visiting this specialist. They call him partly a psychologist - the doctor understands his patients so subtly.

Elena Fridkina

And on Maroseyka, near Kitay-Gorod, you can get an appointment with pediatric gastroenterologist Elena Fridkina, whose experience in medicine is almost thirty years, and her experience and competence leave no doubt. She deals with various issues: diagnoses and treats all kinds of diseases of various organs of the digestive system. In addition, Dr. Friedkina can help in the field of nutrition, as he has this additional specialization. At the same time, the cost of her services is not so high, especially in comparison with the above-mentioned professionals - only 1650 rubles. Patients speak favorably of this doctor, noting her ability to find an individual approach to each patient, her desire and ability to delve into the problem of another person and help deal with it.

Briefly about the main

And one more doctor needs to be said separately in the end - about the main pediatric gastroenterologist. On the website of the Department of Health of the capital, it is indicated that Tamara Skvortsova is such (though freelance). In combination, she works as the head of the department of gastroenterology and manages the center for pediatric gastroenterology at the Morozov Children's City Clinical Hospital.

Medical staff

Shchigoleva Natalya Evgenievna
Head department - gastroenterologist

Education: higher medical, graduated from the 2nd MOLGMI named after N.I. Pirogov in 1986
Doctor of the highest qualification category

Gryaznova Ekaterina Igorevna
Gastroenterologist

Education: higher medical education, graduated from the State Educational Institution of Higher Professional Education of Russia, Russian State Medical University in 2008.
Diploma specialty: "Pediatrics", qualification: "Doctor"
Certificate in Gastroenterology, valid until 2017 inclusive

Ponomareva Anna Petrovna
Gastroenterologist

Education: higher medical, graduated from the Russian State Medical University in 2000.
Diploma specialty: "Pediatrics", qualification: "Doctor"
Certificate in the specialty "Gastroenterology", valid until 2018 inclusive
Academic degree: candidate of medical sciences

A wide range of instrumental, laboratory and genetic studies.
Gastroscopy in the state of medical sleep under the supervision of experienced anesthesiologists.
Diagnostics and treatment according to international standards accepted in leading clinics in Western Europe and the USA.

Children often complain of abdominal discomfort, heartburn, nausea, sore throat, and sometimes dizziness. These symptoms may be manifestations of a disease such as (reflux of acidic contents from the stomach into the esophagus). Reflux can also be manifested by unusual symptoms: recurrent runny nose, hoarseness, coughing, frequent sighing.

Increasingly, children are diagnosed with malabsorption syndrome - a syndrome of malabsorption in the small intestine of certain foods, which is accompanied by diarrhea or constipation, discomfort, bloating, sometimes skin rashes, impaired growth and weight gain.

Changes in the structure and size of the pancreas, an inflection in the gallbladder are often detected. By themselves, they are not a cause for concern, but in combination with complaints of abdominal pain, changes in appetite, stool, indicators of the physical development of the child, they require additional examination to identify the cause of indigestion.

IMPORTANT! Acute and sudden abdominal pain, vomiting, diarrhea, the appearance of blood in the stool - this is an occasion to urgently contact a pediatrician.

While periodically occurring, associated or not associated with food intake, the appearance of pain at night, a feeling of nausea, a decrease in the activity of the child most often involves a planned additional examination.

The Children's Clinic uses a wide range of instrumental and laboratory studies, as well as genetic tests:

Ultrasound with diagnostic tests;
x-ray studies;
gastroscopy (endoscopic examination of the esophagus, stomach, duodenum and small intestine) for children, if necessary with a simultaneous biopsy of the mucosa and removal of foreign bodies;
breath test for the presence (HELIK-SCAN);
colonoscopy with biopsy of the intestinal mucosa.

Gastroscopy can also be done for children at the EMC Children's Clinic in Moscow at the same time and in a state of medical sleep under the supervision of experienced anesthesiologists.

A pediatric gastroenterologist performs diagnostics and treatment in accordance with international standards adopted in leading clinics in Western Europe and the USA. Parents receive the most detailed information about the disease, about the causes of its occurrence. A child with suspected gastroenterological pathology is first examined by a pediatrician to make a preliminary diagnosis. When the profile of the disease is confirmed, the small patient is referred for a consultation with a pediatric gastroenterologist.

Treatment of diseases of the digestive system is not only taking medications. Daily routine, balanced and healthy nutrition, physical activity - all this is not only necessary, but also individually for each child. Recovery of digestive function is a long process. Parents often have questions and difficulties, so our doctors are always open for dialogue and are in touch with parents on any issue.

A pediatric gastroenterologist consults young patients at the EMC Children's Clinic at the address: Moscow, st. Trifonovskaya, 26.

General gastroenterology , as a science, was formed at the beginning of the nineteenth century. She studied the structure and diseases of the gastrointestinal tract and organs directly involved in digestion. Among them are the stomach, liver, bile and bile ducts, pancreas. Recently, however, diseases of the gastroenterological direction have become much younger, more often they began to occur in young people. Although at all times diseases of this kind were common in all age categories. Disorders of the stomach and intestines are observed in both infants and the elderly. But today our conversation will focus only on pediatric gastroenterology . This is a relatively new trend.

What does a pediatric gastroenterologist do?

It is not uncommon for children to have digestive problems: infants, preschoolers and teenagers. This is partly due to malnutrition, an unhealthy lifestyle, the use of products containing many harmful additives in their composition: preservatives, dyes, stabilizers, emulsifiers and other “identical to natural” flavors. The main problem is that children are much more likely to have problems with the digestive organs and the gastrointestinal tract. But not all parents understand that visiting a pediatric gastroenterologist necessary even in a relatively favorable state of affairs. After all, children do not always pay attention to specific ailments, and they cannot always clearly and understandably explain to their parents what worries them. Work specifics pediatric gastroenterologist is a sensitive and attentive attitude towards children. Of great importance in their work is the ability to establish friendly contact with a small patient, to inspire confidence and a sense of security in him. After all, almost all children at the sight of a white coat, and feeling the specific smell of the office, begin to act up and refuse to be examined. The next feature of the work pediatric gastroenterologist is the fact that the structure and functioning of the children's organs responsible for digestion is somewhat different from the adult digestive system. These differences are especially pronounced in the first year of life. The difference can be traced in everything: in the anatomical location and structure of organs, their sizes. The ability of children's organs to produce the appropriate enzymes in children is absolutely atypical. Therefore, the diagnosis and treatment and prevention of diseases of the gastrointestinal tract and digestive system in children requires specific knowledge and a special approach.

Features of the child's body

First of all, in addition to knowledge about the features of the functioning of children's organs, each qualified gastroenterologist must also take into account age. Each age category has its own specifics. And this greatly affects the establishment of the correct diagnosis and the appointment of the correct treatment. After all, it is no secret to anyone that children of different ages react differently to the same medications. Young children and infants are more likely to suffer from "functional" disorders of the digestive system:

indigestion;

dyspepsia;

swelling;

lactose deficiency;

regurgitation syndrome;

dysbacteriosis;

gastroduodenitis;

enterocolitis;

functional constipation.

The older the child becomes, he has an increased chance to get rid of troubles with the intestines and stomach, he, as it were, outgrows infantile diseases. This feature is due to the regenerative-restorative feature of the child's body. We adults can only dream of something like this. However, for this it is important that parents remember that the necessary conditions must be created for the child in order for him to successfully outgrow digestive problems. And ideally, this process should take place under the constant supervision of a qualified pediatric gastroenterologist . Such diseases, by special order of the pediatrician, are examined using the methods of hardware diagnostics and appropriate laboratory tests are carried out.

What diagnostic methods does a pediatric gastroenterologist use?

Diagnostic methods:

Problems with the gastrointestinal tract in children should not be left without due attention. The predisposition of the child's body to such diseases is laid down during pregnancy, and at this time the future person's own biocenosis is laid down, and their own immunity and defense mechanisms begin to form. Therefore, if the pregnancy of the expectant mother proceeds normally, then you can be sure that the child will not have problems with the intestines and stomach.

Causes of diseases

The main reasons for the formation of problems with the gastrointestinal tract in children and infants are the following points.

All these problems directly affect the formation of the child's gastrointestinal tract, the development of the pathology of the digestive system and the whole organism. However, such problems are not limited to the described reasons. No less impact on the gastrointestinal tract and digestive system have a variety of stressful situations. Especially if they cannot be avoided for a long time. Adolescents are prone to such disorders, and during the period when they have to attend kindergarten or school. If the gastrointestinal tract does not work normally, then, as a rule, the body does not receive a large amount of nutrients necessary for growth and proper development. In this case, the child lags behind his more healthy peers in growth, physical and mental development.

Indications for visiting and symptoms

The fact that it is impossible to leave without due attention the child's complaints about feeling unwell was mentioned above. But I would like to dwell in more detail on the symptoms and signs of gastric and intestinal disorders, so that parents immediately take appropriate measures when they are detected. So, if you notice that your child has:

Then you definitely need to get to know a good pediatric gastroenterologist . Take care of yourself and your children. Do not be lazy to contact a specialist for help!