Gastroenterology department. Center for Pediatric Gastroenterology, Morozov Children's Clinical Hospital When you don't have to endure

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!

As part of the Moscow healthcare reform, the City Center for Children's Gastroenterology was organized on the basis of the Department of Gastroenterology of the Morozov Children's Hospital, the tasks of which are:

providing specialized, high-tech care to children and adolescents with diseases of the gastroenterological profile: inflammatory bowel disease - Crohn's disease, ulcerative colitis; short bowel syndrome, stoma, etc.;
improving the system of medical care for children;
coordination of activities of institutions of different levels;
introduction of new effective diagnostic, surgical and therapeutic techniques;
ensuring the rehabilitation and social adaptation of children with gastroenterological pathology;
Information support.

Morozov Children's Clinical Hospital is responsible for drug supply and proper use of high-tech, effective and expensive drug Remicade (infliximab) in children with IBD. The Center produces prescriptions, and special conditions have been created for the correct and safe administration of the drug (anticytokine therapy). The state of the immunological status of patients with IBD is monitored in accordance with the developed modern treatment standards. The Center carries out consultative and diagnostic work on the complex therapy of severe, resistant to standard therapy, inflammatory bowel diseases in children.

The center provides medical care to children and adolescents with diseases that lead to the formation of a stoma.
The Center hosts:

medical consultation;
individual selection of modern stoma care products;
issuing preferential prescriptions for stoma care products;
educate the patient and their relatives on the use of the recommended stoma care products.

The medical staff of the Center for Pediatric Gastroenterology:

Skvortsova Tamara Andreevna - Head of the Center for Pediatric Gastroenterology and the Center for Allergic Healthcare, Morozovskaya Children's Clinical Hospital of the Children's Health Department, Candidate of Medical Sciences, gastroenterologist, chief freelance pediatric gastroenterologist in Moscow
Glazunova Lyudmila Vladislavovna - pediatrician, gastroenterologist, deputy head of the gastroenterological service of the Morozov Children's Hospital
Mukhina Tatyana Fedorovna - pediatrician, gastroenterologist of the highest category
Goryacheva Olga Aleksandrovna – pediatrician, gastroenterologist, candidate of medical sciences
Sarycheva Alexandra Andreevna – pediatrician, gastroenterologist

Pediatric gastroenterologist

A pediatric gastroenterologist is a doctor who diagnoses and treats diseases of the gastrointestinal tract in children: the esophagus, stomach, intestines, pancreas, liver, gallbladder. Children's gastrointestinal tract is characterized by delicate mucous membranes and their abundant blood supply. Due to less secretion of gastric juice and its low bactericidal properties, the child is more susceptible to causative agents of gastrointestinal infections, and many diseases of the digestive system begin in childhood.

If you need a doctor's consultation, you can make an appointment with the pediatric gastroenterologist of the Family Doctor clinic network by calling the 24-hour phone or leaving a request on the website.

Diseases treated by a pediatric gastroenterologist

1. Diseases of the esophagus:

reflux esophagitis - the occurrence of erosive formations of the esophageal mucosa, caused by the reverse reflux of the contents of the stomach into the esophagus.

2. Diseases of the stomach:

gastritis - inflammation of the gastric mucosa, leading to a violation of its functions;

ulcer of the stomach and duodenum.

3. Diseases of the pancreas:

pancreatitis - inflammation of the tissue and ducts of the pancreas. In children, the chronic course of the disease is more common, leading to a gradual violation of the functions of the organ.

4. Diseases of the liver and biliary tract:

hepatitis - inflammation of the liver, most often of a viral origin;

obstruction of the bile ducts - their blockage against the background of cholelithiasis, tumors or inflammation of the bile ducts.

5. Intestinal pathologies.

colitis - inflammation of the large intestine, causing abdominal pain and changes in stool;

duodenitis - inflammation of the duodenal mucosa;

enteritis - acute or chronic inflammation of the small intestine;

celiac disease - damage to the intestinal mucosa due to gluten intolerance;

stool disorders - diarrhea, constipation, discoloration of feces, not associated with the use of coloring products;

dysbacteriosis is a violation of the intestinal microflora.

Any problems in the functioning of the digestive system or a child's complaints of abdominal pain should be the reason for an appointment with a pediatric gastroenterologist, since only the identification and treatment of pathology at an early stage of development will save the patient from possible complications.

Symptoms that should be the reason for contacting a pediatric gastroenterologist

If a child has at least one of the listed symptoms, a pediatric gastroenterologist should be seen.

1. Chronic constipation.

It happens psychologically when the baby is clamped and prevents the exit of feces. But it can also indicate dysbacteriosis, gastroduodenitis, dysfunction of the digestive glands, helminthiasis, polyps, and intestinal tumors. An appointment with a pediatric gastroenterologist is necessary if the child empties the intestines only 1-2 times a week, experiencing pain.

Its most common cause is infection with rotavirus infection or pathogenic bacteria. Diarrhea can also be caused by secretory insufficiency of the gastrointestinal tract. Blood, mucus, food debris in the feces are characteristic of colitis, enteritis, biliary dyskinesia. In these cases, treatment should be started immediately.

3. Nausea and vomiting.

4. Lack of appetite, weight loss.

In some cases, they indicate gastroenterological diseases: stomach and duodenal ulcers, colitis, hepatitis, intestinal dysbacteriosis or celiac disease.

5. Strong flatulence.

In newborns, colic is a temporary physiological feature. At preschool and school age, increased gas formation can be caused by an unbalanced diet or be a symptom of serious dyspeptic diseases: inflammation of the pancreas, stagnation in the intestines, mucous colitis, etc. In the latter case, the child should be taken to a pediatric gastroenterologist for treatment.

6. Pain in the abdomen.

They are caused by inflammatory, mechanical causes, constipation, tumors, acute and chronic infectious diseases. An appointment with a pediatric gastroenterologist, for example, is needed for regularly occurring pain in the abdomen of a child. In case of acute pain in the abdomen, an ambulance should be called.

7. Bad breath.

acetone smell appears with dysbacteriosis, helminthiasis, diseases of the pancreas;

putrid - with low acidity of the stomach and diseases of the esophagus;

sour - with high acidity of the stomach, gastritis and reflux esophagitis;

sweetish - with liver diseases;

chemical - with biliary dyskinesia.

Diagnosis of pediatric gastroenterological diseases

The primary appointment with a pediatric gastroenterologist includes an examination of the child:

palpation of the abdomen;

tapping of the abdominal region;

skin check;

examination of the oral cavity;

conducting a breath test for Helicobacter pylori (if necessary) - the causative agent of inflammation of the stomach and duodenum.

Changes in the color of the skin, oral mucosa, localization of pain when probing the abdomen, collecting patient complaints allow the doctor to make a preliminary diagnosis, prescribe a number of tests and studies.

1. Analyzes.

General analysis of blood and urine - show the general condition of the body.

Biochemical blood test - diagnosis of metabolic disorders.

Analysis of feces for coprology - the identification of pathologies of all organs of the digestive system.

Analysis of feces for dysbacteriosis - determination of the composition of the intestinal microflora.

Analysis of feces for carbohydrates - diagnosis of lactase deficiency in a child.

2. Visualization methods.

Ultrasound of the abdominal organs is a standard examination for parenchymal (dense) organs of the digestive system. Problems of hollow organs (esophagus, stomach, intestines) are usually not detected by ultrasound diagnostics.

Magnetic resonance imaging (MRI) - examination for suspected tumors, gallstone disease or pancreatitis.

X-ray - for the diagnosis of intestinal obstruction, congenital malformations of the intestine, chronic enteritis, ulcerative colitis and some other pathologies.

3. Endoscopic methods.

They are prescribed for the diagnosis of diseases of the digestive system with regular pain in the abdomen, the presence of neoplasms, malformations of the gastrointestinal tract. Endoscopy allows you to take biomaterial for analysis, carry out treatment and perform manipulations to stabilize the child's condition with internal bleeding, acute intestinal obstruction, the presence of foreign objects in the esophagus, stomach or intestines. In pediatric gastroenterology, it is used:

gastroscopy - endoscopy of the esophagus and stomach.

colonoscopy - endoscopy of the rectum and colon.

A pediatric gastroenterologist at the Family Doctor clinic in Moscow can offer to perform the procedure on a child over 7 years old in a state of drug-induced sleep.

Treatment methods used by a pediatric gastroenterologist

1. Conservative treatment.

Therapy with drugs.

Physiotherapy.

It is prescribed at the appointment of a pediatric gastroenterologist with irritable bowel syndrome, constipation, decreased intestinal motility, gastritis and some other diseases. Physiotherapy includes:

medicinal electrophoresis;

applications with paraffin, ozocerite;

ultrasound therapy;

Compliance with a special diet.

Exclusion from the diet of fatty, fried, spicy, salty foods, rejection of chips, soda, smoked meats and other harmful substances and switching to natural baked, boiled or steamed food.

2. Surgical treatment.

In some cases, surgery is indispensable, for example, with inflammation of the appendix, cholelithiasis (with the threat of complications), malignant tumors and some others.

An emergency operation is required in case of perforation of the stomach wall, opening of bleeding caused by the progression of peptic ulcer, and other urgent conditions (appendicitis, peritonitis, diverticulum rupture, etc.)

In intestinal obstruction, surgery is necessary to remove the blockage and remove part of the intestine.

Intestinal polyps require mandatory removal. With multiple polyposis, it may be necessary to cut out the affected part of the intestine.

Surgical intervention is used as an extreme measure for the treatment of duodenitis with the ineffectiveness of conservative treatment or the patient's serious condition.

If you find symptoms of diseases of the digestive system in a child, you should immediately contact a specialist. An appointment with a pediatric gastroenterologist is possible on the website of the Family Doctor clinic, which has a network of branches in different parts of Moscow.

We are waiting for you in the network of clinics "Family Doctor"!

This is a specialist who deals with the diagnosis, treatment and prevention of the pathology of the digestive tract in children. Diseases of the digestive system are among the most common today. Their causes are varied: from unbalanced nutrition to stress, and the child's body is least protected from the effects of these factors. That is why the consultation of a pediatric gastroenterologist is necessary in case of any problems associated with the digestive system.

If you are looking for a pediatric gastroenterologist in Moscow, please contact the CELT multidisciplinary clinic. We employ leading domestic specialists who have extensive experience and have all the means to determine the cause of the disease, correctly diagnose and prescribe effective treatment.

Why is it necessary to contact a pediatric gastroenterologist?

A good pediatric gastroenterologist is essential for many young patients with digestive problems. It is no secret that childhood has its own anatomical and physiological characteristics. This rule also applies to the gastrointestinal tract. Therefore, it is obvious that the child should be consulted by a specialist in pediatric practice.

When is it necessary to contact a pediatric gastroenterologist?

A number of clinical manifestations should be the reason for visiting a pediatric gastroenterologist:

pain in the abdomen of varying intensity, different nature and any localization;
nausea and vomiting;
heartburn and belching;
loss of appetite;
bad breath;
stool disorders: constipation, diarrhea;
flatulence, increased gas formation in the abdomen

An urgent consultation also requires a suspicion of bleeding from the gastrointestinal tract, which manifests itself in the form of vomiting with an admixture of blood, black stools, stools with an admixture of blood. Such situations are rare, but should be regarded as life-threatening, and therefore immediately managed in a hospital setting!

During the reception

At the consultation, a pediatric gastroenterologist conducts an initial examination and listens to complaints that are available. It is very good if the parents bring to the consultation the data of all diagnostic studies, if any have been carried out before, as well as the previous conclusions of the specialists. This will save both time and money. In order to make a diagnosis, pediatric gastroenterologists at the CELT clinic conduct a comprehensive examination, which is prescribed based on the specific clinical situation and may include the following:

ultrasound examination of the abdominal cavity;
x-ray examination;
endoscopic examination (gastroscopy);
blood, urine, stool tests.

If the situation requires it, a pediatric gastroenterologist can join forces with other specialists in pediatric practice (neurologist, surgeon, endocrinologist, otolaryngologist, dentist, pediatrician) to jointly evaluate the results of a diagnostic examination and draw up an individual treatment program.

CELT multidisciplinary clinic: we will take care of your baby's health!

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.