Gastroenterology & Hepatology Specialized Programs

Within our specialized programs pediatric gastroenterologists work with other pediatric specialists, surgical specialists, speech and language therapists, dietitians, nurse coordinators, child life specialists and social workers. Team members are specially trained in childhood development. Working in tandem with the family, the team establishes an individualized care plan for each patient to address his/her unique needs.

The dedicated medical team of this program provides coordinated care for children and adolescents with airway, breathing and swallowing disorders caused by problems in the aerodigestive tract (throat, lungs, esophagus and stomach).

In the Celiac Program, we provide coordinated care for children and adolescents with possible and confirmed celiac disease and other gluten-related disorders. Our physicians and dietitians are dedicated to the education and maintenance of a gluten-free diet and ensuring that each child’s diet is well balanced.

Children with type 1 diabetes mellitus are at high risk for developing celiac disease. To better accommodate these families, children with both type 1 diabetes and celiac disease can arrange to have appointments to see both their endocrinologist and gastroenterologist on the same day.

Constipation is a common pediatric condition and accounts for 25% of all visits to a pediatric gastroenterologist. While some patients respond well to dietary changes and laxative therapy, others require a more individualized and multidisciplinary approach. This program provides a dedicated clinic for pediatric patients with refractory or chronic constipation.

Dietary changes are a key part in establishing good health along with any necessary medications. The proper diet can decrease the need for long-term medications, and may be used exclusively to prevent constipation. Our gastroenterologists are passionate about using nutritional approaches to improve the health of children. They work closely with dietitians to review the child’s dietary history and provide recommendations to improve his/her health and well-being. By providing guidance in healthy food choices to treat and prevent constipation, the care team reduces the need for long term laxative therapy.

Treatment of eosinophilic esophagitis and other GI allergies can be challenging, with most children requiring either long term medical therapy or dietary modification. The Eosinophilic Esophagitis team including gastroenterologists, allergists, dietitians and nurses collaborate to manage medical and dietary symptoms, monitoring growth and nutrition of the child, and therapeutic interventions when needed including: 

  • Medical and dietary therapy for eosinophilic esophagitis and other gastrointestinal allergies 
  • Diagnostic/endoscopic monitoring of eosinophilic esophagitis 
  • Dietitian guided nutritional monitoring of macronutrient and micronutrient intake 
  • Dietitian guided dietary supplementation 
  • Endoscopic and surgical dilations and injections of strictures 
  • Feeding therapy 

The Pediatric Hepatology program at Yale New Haven Children’s Hospital treats children with a wide range of liver diseases. A multidisciplinary team provides comprehensive care for patients with fatty liver disease and includes a clinical psychologist, dietitian, pediatric endocrinologists and pediatric hepatologists. Similarly, patients with biliary atresia are cared for by a team comprised of pediatric hepatologists, pediatric surgeons, a dietitian and transplant surgeons. The program also offers selective shunts for patients with non-cirrhotic portal hypertension. 

Our team has cared for pediatric liver transplant recipients with a combined experience of over two decades and is committed to providing the best possible outcomes for our patients. They realize some conditions can be managed with medication, while others require surgery. Taking a family-centered care approach, they work with the entire family to treat the child, not just the disease. 

Conditions we treat

Acute Liver Failure

Acute liver failure (ALF) occurs when many of the cells in the liver die or become very damaged in a short period of time. ALF has many causes, such as metabolic conditions or toxicity from incorrect dosage of acetaminophen. ALF can sometimes be treated with medication, if it is identified early. 

Biliary Atresia

Biliary atresia is a disease of the liver and bile ducts that occurs in infants. In children with biliary atresia, bile – a liquid that helps the body digest fat – cannot properly drain from the liver. This damages liver cells and can lead to liver failure. Surgical procedures can correct bile flow problems, but the liver disease progresses and requires specialized care to improve growth, development, nutrition and long-term outcomes, which is what our program addresses.

More conditions we treat

  • Alagille syndrome 
  • Alpha-1-antitrypsin deficiency 
  • Autoimmune hepatitis 
  • Neonatal cholestasis 
  • Progressive familial intrahepatic cholestasis (PFIC) 
  • Urea cycle defects 
  • Wilson’s disease 
  • Primary sclerosing cholangitis 
  • Glycogen storage disease 
  • Viral hepatitis 
  • Hepatoblastoma 

Our Inflammatory Bowel Disease (IBD) Program is dedicated to providing comprehensive and multidisciplinary management of inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis in children.

We have an expert IBD team that consists of pediatric gastroenterologists, surgeons, a nurse coordinator, social worker and nutritionist. Our aim is to improve psychological health and to promote optimal growth of all children and adolescents with IBD. We are proud to report that remission rates in our patients are better than the national benchmark and our patients can participate in clinical research. 

Diagnosis

We use the latest technology to diagnose IBD in children. The team performs a complete medical history, and physical examination as well as diagnostic procedures such as blood tests, stool tests, CT scan, magnetic resonance imaging (MRI), endoscopy, colonoscopy and video capsule endoscopy. 

Video capsule endoscopy is a test where you ingest a capsule that contains a tiny camera and a light source. The camera takes pictures of the small intestine for 8 hours as it travels through the digestive tract. The images from the camera are transmitted to a sensor belt and recorder that are strapped onto your body. The capsule is then expelled naturally through a bowel movement. A video capsule endoscopy may be ordered when the small intestine needs to be visualized to evaluate certain conditions or symptoms. This includes conditions such as Crohn’s disease, iron deficiency anemia or a gastrointestinal (GI) bleed. 

Treatment

We offer current medical therapies including different medications such as amino salicylates, immunomodulators and biologic therapy. Our nutritionist advises children and families about diet and food choices to ensure optimal nutritional status and growth. Our social worker helps children and families cope with stress and psychosocial issues at work and at school. We have a dedicated team of surgeons who employ the latest techniques of laparoscopic surgery through small incisions for rapid recovery. We have a well-developed transition plan to transfer our patients after 21 years of age to our adult gastroenterologist colleagues.

Our Short Bowel Rehabilitation Program cares for patients who have undergone bowel resection due to a variety of reasons including impaired intestinal function from inflammatory conditions such as inflammatory bowel disease. 

These children are closely monitored to maximize their growth and nutrition. We work closely with our feeding program to ensure that children are meeting milestones in oral motor development and encourage feeding orally when medically possible. 

Our surgeons have extensive expertise in intestinal lengthening procedures including serial transverse enteroplasty (STEP). STEP increases the absorptive surface area of the small intestines and may decrease intestinal motility to enhance nutrient absorption.