Paediatric Gastroenterology

Best Paediatric Gastroenterologist Hospital in Bangalore

Paediatric Gastroenterology, Hepatology, and Nutrition is a speciality that is dedicated to providing expert care for young patients with gastrointestinal issues. The team of paediatric gastroenterologists are experienced in diagnosing and treating a wide range of digestive disorders in children, ensuring each patient receives personalised and compassionate care in a supportive environment. Our expert paediatric gastroenterologists at Manipal Hospital Old Airport Road can diagnose and treat common problems like constipation and diarrhoea as well as more complex conditions like Crohn's disease and ulcerative colitis.

Why Manipal Hospitals?

The Paediatric Gastroenterology Department at Manipal Hospital Old Airport Road Bangalore is renowned for its exceptional patient care and medical expertise. Our paediatric gastroenterology specialists are capable of handling complex cases with skill and precision. We utilise the most advanced medical technologies available. This includes sophisticated diagnostic tools and therapeutic devices, ensuring our young patients receive the most accurate diagnoses and effective treatments, like endoscopic procedures, biopsies, etc. 

Beyond medical treatment, our approach integrates nutritional guidance and psychological support. We focus on the overall well-being of our patients, addressing every aspect of their health.

Consult our paediatric gastroenterologist Bangalore for diagnosis and treatment for digestive issues affecting children.

Diseases Treated by Paediatric Gastroenterologists

Luminal Gastroenterology

Gastroesophageal Reflux Disease (GERD)

GERD, a chronic digestive disorder, happens when the acid content of the stomach repeatedly flows back into the oesophagus (food pipe). Our approach begins with a thorough assessment of symptoms like heartburn, regurgitation, and discomfort. We focus on lifestyle modifications, dietary changes, and medications to manage acid production. For persistent cases, we explore advanced options like surgical interventions and continuous monitoring to prevent complications like esophagitis.

Inflammatory Bowel Disease (IBD)

Inflammatory Bowel Disease (IBD) occurs when there is chronic mucosal inflammation of the intestine. It results from a complex interplay of various factors such as genetics, environmental, and adaptive immunity of a child. There are two types of IBD- Crohn's disease and ulcerative colitis. Even though IBD cannot be cured, we can control the disease in children and teenagers with proper management programs that may commonly include medication management, diet modification, lifestyle changes, growth and development monitoring, and psychological support. In some severe cases, surgery becomes the last and inevitable option. 

Chronic Diarrhea

Diarrhea is loose, watery stools that can be accompanied by cramps in the abdomen. This occurs once in a while due to viruses, stomach infections, or food intolerance. Usually, it subsides on its own in a day or two. However, if it persists longer than usual, a consultation with a doctor is required. Chronic diarrhoea is persistent diarrhoea that lasts for more than a month. 

At Manipal Hospital Old Airport Road, we begin the treatment of chronic diarrhoea by examining your child’s diet, whether something s/he regularly eats or drinks may be causing loose motions, and identify underlying conditions if any. Hydration is also important when your kid develops diarrhoea. Have enough water and electrolyte solutions added to the water to keep them hydrated. Whether it requires complex treatment or just dietary and medical management, our Paediatric Gastroenterologists in Bangalore are well-experienced to help your kid with suitable treatment options. 

Pancreatic Disorders

Acute & Chronic Pancreatitis

Pancreatitis is an inflammation of the pancreas that can be sudden (acute) or long-standing (chronic), causing stomach pain, vomiting, and nausea. Acute pancreatitis may sometimes resolve on its own and doesn’t require any intervention. However, we conduct a thorough evaluation to determine the cause of both types of pancreatitis, be it gallstones or genetic factors. Treatment focuses on pain management, nutritional support, and treating the underlying cause. We provide long-term management strategies to prevent flare-ups and complications in chronic cases.

Dyspepsia Diagnosis and Management 

Dyspepsia, a common condition among children, causes recurrent pain and discomfort in the upper abdomen. We offer a comprehensive evaluation of indigestion symptoms, considering factors like diet, stress, and medication. Treatment plans are personalised, often involving dietary adjustments, stress management, and medication for acid suppression. We emphasise patient education and regular follow-ups for effective management of symptoms.

Gastritis Care

Gastritis is inflammation or irritation of the stomach lining in children due to bacterial or viral infections, stomach or intestinal injuries, or Autoimmune disorders like Crohn’s disease. Our approach includes a detailed assessment of symptoms like abdominal pain and nausea and diagnostic tests to identify the cause (like H. pylori infection). Treatment usually involves dietary modifications, medications to reduce acid production, and addressing underlying causes. We provide ongoing support and advice to prevent recurrence.

Gallbladder Stone Management

Gallbladder stones in children with no symptoms often don’t require surgical intervention. If the child develops symptoms, surgery is effective to remove the gallbladder. We offer a range of treatments, from non-surgical approaches like dietary changes and medications to dissolve stones to surgical options like cholecystectomy for symptomatic gallstones.

Liver Disorders

Wilson’s Disease

Wilson’s Disease, a rare genetic disorder, is commonly found in children. This causes large amounts of copper to build up in the liver and brain. At Manipal Hospital Old Airport Road, our management mainly includes medications to remove excess copper and prevent its accumulation, dietary advice to avoid copper-rich foods, and regular monitoring to manage the condition effectively. In severe cases when it causes acute liver cirrhosis or failure, a liver transplant becomes the best option.

Biliary Atresia

Biliary atresia is a rare liver disease that occurs in infants shortly after birth, affecting tubes in the liver called bile ducts and restricting bile (a substance produced in the liver) from passing to the small intestine. Our team of paediatric gastroenterologists in Manipal Hospital Old Airport Road, Bangalore often manage this condition with surgical interventions. As it causes scarring and damage to the liver, most of these babies end up requiring liver transplants for a long and healthy life.

Hepatitis Care

Hepatitis is an inflammation of the liver which occurs due to several viruses (viral hepatitis), contamination of water and food (hepatitis A, B, C, D, etc.), or certain genetic or autoimmune disorders (autoimmune hepatitis). It can be acute (sudden flares up without no prior liver issues) or chronic (long-term with pre-existing liver diseases). 

Our treatment for hepatitis varies based on its type. We offer antiviral medications for viral hepatitis, immune-suppressing medications for autoimmune hepatitis, and lifestyle changes. Regular monitoring and liver function tests are integral to our care plan. Patient education about the condition and lifestyle modifications also play a key role.

Metabolic Liver Disease

We bring together a team of multidisciplinary specialists who offer personalized care and advanced treatment options to patients with Metabolic liver diseases, damaging the liver's capacity to digest and metabolise nutrients and causing toxic compounds to accumulate in the body. These diseases can be inherited or acquired and can cause liver damage, reduced function, liver cirrhosis and even failure, and liver cancer.

Choledochal Cyst Treatment 

A choledochal cyst, a congenital abnormality of the bile duct (tube), causes the bile to become bigger than normal (dilate) or form pouches. Our approach includes surgical intervention to remove the cyst and reconstruct the bile duct, followed by regular follow-ups to monitor for complications and ensure proper bile flow.

Nutritional Disorders

Malnutrition

Malnutrition is a condition when your body doesn’t have enough nutrients like vitamins, minerals, fibre, protein, etc. This imbalance in dietary intake is often caused by hunger, a poor diet with a lack of nutrition-based ingredients, or any digestive issues. If this condition isn’t treated on time, it can lead to physical or mental disability.

Our approach to treating malnutrition includes looking at the symptoms of fatigue, dizziness, and weight loss and addressing any underlying conditions if found. A balanced dietary regime planned with the help of our dietician can further help these children get the nutrients their body needs to function properly.

Obesity & Fatty Liver

Unhealthy diets and malnutrition have a double burden of undernutrition as well as Obesity and other diet-related non-communicable diseases. Diet also plays a key role in the development of Non-alcoholic fatty liver disease (NAFLD). 

Kids with obesity and fatty liver disease require a comprehensive approach where our Paediatric Gastroenterologists in Bangalore help them prevent and manage both obesity and NAFLD through nutrition and lifestyle factors and medical management along with other interventions if required. Our dietitian can also help create a personalized plan that promotes weight loss or maintenance and improves liver health.

Enteral and Parenteral Nutrition

Enteral and Parenteral Nutrition are forms of artificial nutrition provided to kids when they’re nutrition deficient. Enteral Nutrition involves feeding of liquid supplements through a tube that directly delivers nutrition and calories into the stomach or small intestine. Parenteral, which means ‘outside of the digestive tract’, requires feeding intravenously (through a vein) whereby nutrients enter the bloodstream.  

When normal eating and drinking becomes difficult or impossible for your child due to medical issues, these feeding techniques can help them get the nutrition they need for their body to function. 

Procedures

Endoscopy 

Endoscopy is generally painless, but some discomfort due to air insufflation might be experienced. For children, especially those under 14 years, sedation or anaesthesia is used to ensure comfort. These endoscopy procedures enable various interventions such as polypectomy (removal of polyps), vascular hemostasis (stopping of bleeding), and PEG tube insertion as needed. They are usually day-care procedures, allowing for the same-day discharge of children. The following key endoscopy procedures are performed:

• Upper GI Endoscopy: Examines the upper digestive tract (oesophagus, stomach, small intestine) using a camera-mounted tube.

• Sigmoidoscopy and Colonoscopy: Inspects the lower digestive system, with sigmoidoscopy focusing on the sigmoid colon and rectum and colonoscopy covering the entire colon.

• Enteroscopy: A specialized procedure using a balloon-assisted scope to visualise the small intestine.

Endoscopic Retrograde CholangioPancreatography (ERCP)

This procedure is critical in the diagnosis and management of various biliary and pancreatic conditions, providing minimally invasive solutions for complex problems. The ERCP test takes about 20 to 40 minutes, after which the patient is moved to a recovery area. 

ERCP combines the use of an endoscope and x-ray imaging. The patient's throat is anaesthetised, and they are usually mildly sedated. The endoscope is inserted into the upper oesophagus, and a thin tube is passed through it to the main bile duct, entering the duodenum. Dye is injected into the bile and/or pancreatic duct for x-ray imaging.

The procedure allows for removing gallstones, widening narrowed ducts, and placing stents to keep ducts open. If there's damage to the pancreatic ductal system, stenting can be performed to manage enzyme leakage.

Colonoscopy 

Colonoscopy is an essential tool in diagnosing and managing various gastrointestinal conditions, providing valuable insights into the health condition of the lower digestive tract. This involves the use of a colonoscope or scope to examine the interior of the rectum and colon. The procedure is instrumental in identifying various conditions, such as irritated or swollen tissue, ulcers, polyps, and cancer.

Colonoscopy is particularly useful for investigating the root cause of symptoms like bleeding from the anus, changes in bowel activity (such as diarrhoea), abdominal pain, and unexplained weight loss.

Percutaneous Endoscopic Gastrostomy (PEG) Tube Insertion 

Percutaneous Endoscopic Gastrostomy (PEG) Tube Insertion is performed on children who require direct stomach feeding and ensures they receive the necessary nutrition and medication. PEG Tube Insertion is a procedure where a flexible feeding tube is placed through the abdominal wall and into the stomach. It allows for nutrition, fluids, and/or medications to be directly administered into the stomach, bypassing the mouth and oesophagus.

The PEG tube insertion is beneficial for patients who have difficulty swallowing, problems with their appetite, or an inability to take adequate nutrition orally. After the procedure, a dressing is placed on the PEG site, usually removed after one or two days. The site should be cleaned daily with diluted soap and water and kept dry between cleanings. No special dressing or covering is needed post-removal of the initial dressing.

Liver Biopsy

A liver biopsy is integral for accurately diagnosing and managing liver-related conditions, especially liver cancers. This involves taking a small sample of liver tissue to examine under a microscope. A liver biopsy at our hospital is a day-care procedure, meaning the child can be discharged within 24 hours after the procedure. 

After sedation or anaesthesia, a special needle is used to extract a piece of liver tissue, usually under ultrasound guidance. The sample is then tested for various aspects (routine H&E, special stains, liver dry copper).

Liver Transplantation

A liver transplant is a major surgical procedure that replaces a diseased or failing liver with a healthy one from a donor.  It can be a life-saving option when a child's liver is extremely damaged and can no longer function. This happens due to various conditions like biliary atresia, acute liver cirrhosis and failure, inherited and genetic liver disease, viral hepatitis, and liver cancer. 

Like in adults, liver for transplantation in children can come from deceased donors or living donors. In living donor liver transplant, a part of the liver is transplanted. The surgery involves removing the diseased liver and replacing it with a healthy donor liver. The surgical procedure can take several hours. Immunosuppressive medications are needed to prevent rejection of the transplanted organ post-surgery. Careful monitoring and follow-ups with the doctor can further help in recovery and minimizing side effects.

Mickey Button insertion 

Mickey Button insertion is another method that helps children who require direct feeding into the stomach, ensuring they receive the necessary nutrition and medication in a more manageable way. The Mic-Key button is a low-profile gastrostomy tube that allows for direct nutrition, fluids, and medicine administration into the stomach.

The gastrostomy tubes, including the Mic-Key button, are placed laparoscopically in the operating room under general anaesthesia. The procedure typically takes less than thirty minutes. It involves inserting a small camera through the belly button and using an instrument to bring the stomach closer to the abdominal wall. A gastrostomy tube is placed into the stomach from the outside, and a small balloon is inflated inside the button to secure it.

Endoscopic Banding

Endoscopic Banding is an intervention used to manage variceal bleeding, a serious complication associated with conditions like liver cirrhosis and portal hypertension in children. It is used to treat abnormal veins that develop in the oesophagus and are characterised by thin walls with high blood pressure running through them.

Endoscopic banding involves the use of elastic bands to ligate the varices. This is done to prevent bleeding or to manage existing bleeding from these varices.

Endoscopic Sclerotherapy

Much like Endoscopic Banding, Endoscopic Sclerotherapy is also used to treat variceal bleeding, a serious complication associated with liver cirrhosis and portal hypertension in children. It involves the use of an oesophagoscope and the injection of a sclerosing agent into or around oesophagal varices. The paravariceal technique is considered superior to the intravariceal method regarding the recurrence of haemorrhage and long-term results.

Endoscopic sclerotherapy can be performed in three different ways:

•  Injection into the Varices: This method aims to thrombose, obliterate, and eradicate the varices.

• Paravariceal Injection: This technique covers the varices with a fibrous layer.

• Combination of Submucosal and Intravariceal Injection: This approach combines the first two methods.

Enteroscopy 

Enteroscopy uses a thin, flexible tube with a camera called an enteroscope to examine the small bowel. It's an effective method for inspecting the small intestine's lining and identifying any diseases without incision. It also allows for taking tissue samples (biopsy) for analysis if necessary, providing a precise assessment of the small bowel's health.

Three techniques are used for enteroscopy:

• Single Balloon Enteroscopy

• Double Balloon Enteroscopy

• Spiral Enteroscopy

Foreign Body Removal 

It is necessary when people, particularly children, swallow food or foreign objects that become stuck in the digestive tract. While many swallowed objects pass through naturally, some may require medical intervention for removal. The doctor examines the lining of the digestive tract, including the oesophagus, stomach, and upper part of the small intestine, to check for any damage and to remove the foreign object. Endoscopic foreign body removal is a minimally invasive procedure used to extract items lodged in the digestive tract. Emergency medical attention is required if an object is stuck in the airway or obstructs breathing. The typical procedure for removing a foreign body from the digestive tract is an upper endoscopy, also known as an esophagogastroduodenoscopy (EGD).