Treating the Whole Patient in Pediatric GI

When parents visit a gastrointestinal (GI) specialist, they assume they're coming to get a medicine to treat their child, says Joelynn Fitz, DO, pediatric gastroenterologist with Lehigh Valley Reilly Children's Hospital. But each child, whether experiencing abdominal pain, constipation or something else, is unique and requires a comprehensive evaluation.

“No two patients have the same stressors, diet or lifestyle. So it’s important to work with the family to understand what is contributing to the symptoms,” Fitz says. “In GI, we have options for many of the diseases we treat.”

Pediatric gastroenterology treats a broad range of symptoms and underlying diseases in patients from birth through age 18. Most commonly, children present with concerns of abdominal pain, constipation or reflux. Sometimes, symptoms are related to an underlying disease in the intestines like celiac disease or inflammatory bowel disease (IBD), while functional symptoms like pain, nausea or vomiting may indicate a problem with how the nervous system is affecting GI tract performance instead of a condition inside the GI tract, Fitz explains. Irritable bowel syndrome is a common example of a functional GI disorder.

After a complete workup, clinicians may suggest medication, dietary treatments or therapeutic approaches through collaboration with behavioral therapists or other specialists to help decrease pain or discomfort. Gastroenterologists work closely with other pediatric subspecialists, including surgeons if there’s a surgical reason for pain like gallstones, and pulmonologists and otolaryngologists if reflux symptoms coexist with airway or breathing issues.

“With one team across the hall and another right downstairs, we’re able to coordinate our schedules to get patients in to see multiple specialists within the same time frame,” Fitz says, noting both parents and kids prefer one set of tests and visits. “We’re able to provide that coordinated care.”

The pediatric gastroenterology team treats about 125 children with IBD, and more than 90 kids receive their infusion treatments in the Children’s Cancer Center at Lehigh Valley Reilly Children's Hospital.