Pediatric Gastroenterologist. Department of Gastroenterology. C urease breath test

The Gastroenterology Department of the Russian Children's Clinical Hospital was founded in 1989 and has 30 inpatient beds. The department provides highly qualified medical care to patients aged 2 months to 18 years with the following chronic pathology of the gastrointestinal tract:

More than 600 patients from all regions of the Russian Federation are examined and treated annually in the department, 50% of which are patients with ulcerative colitis and Crohn's disease, about 25% - with cirrhosis of the liver and chronic hepatitis of various etiologies.

The main task is to make a diagnosis in a timely manner, using all the diagnostic capabilities of a multidisciplinary hospital, and to prescribe therapy taking into account the individual characteristics of the patient in accordance with Russian and international treatment standards. The department has accumulated extensive experience in the use of anticytokine therapy (drugs "Remicade", "Humira"), modern immunosuppressive drugs in the treatment of inflammatory bowel diseases and autoimmune liver diseases. Physiotherapy, acupuncture, hyperbaric oxygen therapy, physiotherapy exercises and massage are widely used. The average duration of treatment is 15 days.

The structure of the department corresponds to the typical profile of pediatric departments: there are 2-bed, 3-bed rooms, 2 boxes with facilities for the most seriously ill patients, a game room, a classroom, shared showers and toilets.

The department is the base of the Department of Hospital Pediatrics No. N.I. Pirogov" (head of the department - Prof. P.V. Shumilov), cooperates with the Federal State Budgetary Institution "NTsZD", FGBNU "Research Institute of Nutrition", Federal State Budgetary Scientific Institution "RSCH them. ak. B.N. Petrovsky, Federal State Budgetary Institution "FNTsTIO them. ak. IN AND. Shumakov", FNKTs DGOI them. Dmitry Rogachev, Moscow Genetic Research Center.

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

Every mother knows how unpleasant sometimes there are problems with the digestion of the baby. Unfortunately, it is not always possible to solve them on your own. Yes, and risk the health of the child is not worth it. A pediatric gastroenterologist deals with such issues. His duties include the treatment of all organs of the digestive system, as well as the prevention of diseases of the gastrointestinal tract.

What does a doctor do?

A pediatric gastroenterologist deals with the treatment of gastritis, ulcers, colitis, hepatitis and many other diseases. It is worth contacting this specialist as early as possible, while the disease has just begun to develop and has not given complications (for example, gastritis not cured in time can easily become an ulcer over time).

It is important for a doctor not only to diagnose the disease, but also to find out its causes: hereditary predisposition, malnutrition, viral disease, etc. This significantly affects the treatment tactics. A pediatric gastroenterologist directs a small patient to a series of examinations, which include various tests, ultrasound, FGDS (if necessary), talks with the baby's parents and, based on this, selects therapy.

When should you contact a specialist?

It is difficult not to notice problems with digestion in a child. Be sure to make an appointment with a pediatric gastroenterologist if your baby is concerned about:

persistent diarrhea or diarrhoea;
nausea, vomiting;
loss of appetite;
persistent pain in the abdomen;
specific smell from the mouth.

How to become a pediatric gastroenterologist?

If you decide to get such a difficult but useful specialty, then there is a long and difficult path ahead. First you need to get a higher medical education and become a certified pediatrician. There are programs in pediatrics in all medical universities in Moscow. By tradition, the First Moscow State Medical University named after I.I. THEM. Sechenov, RNIMU them. N.I. Pirogov, as well as the Faculty of Fundamental Medicine of Moscow State University. M.V. Lomonosov. In the future, you need to complete residency in the direction you are interested in. Throughout the entire medical practice, constant professional development, exchange of experience with colleagues is necessary. The Scientific Research Clinical Institute of Pediatrics. acad. Yu.E. Voltishchev.

Famous specialists of Moscow

Gastroenterology is a relatively young branch of medicine, because it began to develop around the second half of the 19th century. For a long time, children's diseases were not considered separately and were more likely to be managed by surgery. Only by the end of the last century did children's gastroenterologists actually begin to appear. In 1982, on the initiative of M.B. Kuberger, research on this topic began at the Moscow Research Institute of Pediatrics and Pediatric Surgery, and already in 2000 a specialized hospital appeared. The development of pediatric gastroenterology in Moscow is also associated with the names of A.A. Cheburkina, A.I. Khavkina, A.A. Korsunsky and others.

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!

Diseases of the digestive system are found not only in adult patients, but, unfortunately, in children of different age groups. Errors in the diet, violations of the daily routine can lead to the appearance of various inflammatory processes in the gastrointestinal tract in children, which most negatively affect the growth and development of the child.

A pediatric gastroenterologist in the city of Moscow will help in the diagnosis and treatment. The sooner parents pay attention to the child's complaints, the more effective the result of treatment will be. It is not always possible to cope with the emerging digestive problems in children at home. In this case, it is the specialized help of a gastroenterologist that is needed.

If during the examination and during the examination, the pediatrician in the child suspected a lesion of the digestive organs, the small patient is sent to a gastroenterologist for a consultation. This pediatric specialist is engaged in the diagnosis, treatment and prevention of diseases of the digestive system.

diseases of the esophagus, stomach, duodenum;
bowel disease;
pathological processes in the liver and biliary tract;
diseases of the pancreas;
hereditary metabolic diseases with damage to the liver tissue.

Parents should be attentive to the health of their children and pay attention not only to the complaints of the child, but also to his behavior, since the baby cannot always clearly say: where and how it hurts. The most common health complaints in a child and indications for consulting a pediatric gastroenterologist are:

If a child has such health complaints, consultation with a gastroenterologist should not be delayed. Only a specialist doctor can diagnose a pathology and prescribe timely, high-quality treatment to prevent the transition of the disease to a chronic course.

How to get to a pediatric gastroenterologist

If a child has problems with the digestive organs, the primary examination is carried out by a pediatrician. The doctor prescribes a laboratory examination of blood, urine for a general analysis, feces for helminth and giardia eggs.

If the presence of pathology from the gastrointestinal tract is confirmed, the pediatrician gives a referral to a gastroenterologist. Under the MHI policy, you can get a free initial consultation with a specialist. As a rule, a specialized reception is carried out in a children's city or regional hospital.

But re-admission and additional, both laboratory and instrumental methods of research, will be paid. Therefore, it is better to immediately apply for an appointment at a paid clinic, which you can choose taking into account the equipment, qualifications of the specialist and reviews of the patients' doctor.

Where to go

Large children's medical institutions provide advisory and medical assistance both outpatient and inpatient. Where can I find a pediatric gastroenterologist in Moscow, and which doctor can I recommend? You can make an appointment at the following major clinics:

ATTENTION!!

You are on the unofficial website of the hospital. The information on this site is outdated and is not a public offer.

For up-to-date information, please visit the official website http://morozdgkb.rf

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.