Pediatric GI Programs and Services

Photo of a child sitting on an exam table talking with a healthcare provider
Our programs are part of our pledge to help children feel better and get back to their usual activities.

For a child with digestive symptoms, finding the cause is our first step. We will diagnose, treat and manage your child’s GI condition. Our goal is to help your child feel better and get back to their normal daily life.

On this page, you can learn about:

GI programs and services

Our unique program is a complete approach to caring for children with celiac disease. Your child’s care team will include experts in every area their celiac disease could impact.

What is celiac disease?

Celiac disease is the most common auto-immune disease in children. It causes the immune system to react to gluten by damaging the small intestine. The only way to manage your child’s celiac disease is a gluten-free diet.

How we treat celiac disease

An expert gastroenterologist is just the start. Your child may also see a dietitian, psychologist and social worker. Nutrition and mental health challenges are often part of celiac disease. We can help your child adjust to their diagnosis, cope, set up support at school, and more. We will follow-up regularly with your child, even when they are doing well.

We have the only pediatric IBD program in Oregon right here at Doernbecher. Our pediatric gastroenterologists are experts in IBD and will help your child feel better and get back to their normal daily activities.

What is inflammatory bowel disease (IBD)?

This is a group of auto-immune conditions that affect the digestive system. They can also affect the joints, liver, eyes and skin. Symptoms include:

  • Diarrhea
  • Constipation
  • Abdominal pain
  • Blood in stool
  • Poor growth
  • Low energy
  • Joint pain
  • Skin rashes
  • Anemia

The most common types of IBD are:

Crohn’s disease can affect any part of the GI tract from the mouth to the anus. It can have vague symptoms, like poor growth or abdominal pain.

Ulcerative colitis only affects the colon. Symptoms can be more severe with more diarrhea and blood in the stool and frequent need to use the bathroom at night.

Very early onset IBD affects children less than 6 years old. It may be caused by a genetic immune defect and requires targeted treatment.

Indeterminate colitis is inflammation in the colon that is not defined as Crohn’s disease or ulcerative colitis. It is most common in younger children.

IBD is not the same as irritable bowel syndrome (IBS). IBS can often be treated by a pediatrician, while IBD requires the care of a gastroenterologist.

How we treat IBD

We treat IBD by addressing all of the ways it impacts your child’s well-being. We offer leading medications, as well as access to clinical trials for promising new treatments.

Your child can see every specialist they need in our program. Our team includes IBD-focused gastroenterologists, dietitians, psychologists and nurses. We work closely with pediatric immunology, pediatric surgery and adult IBD specialists.

Our nurse coordinator will help you:

  • Manage your child’s medications.
  • Learn more about their condition.
  • Schedule appointments with our team.
  • Work with your insurance carrier to get medicines and tests approved.

Our program is led by the only board-certified pediatric hepatologist (liver specialist) in Oregon. We provide advanced care for children with liver disease.

What is pediatric liver disease?

Liver disease in children includes a range of conditions with different causes and symptoms. All childhood liver conditions require specialty care.

How we treat pediatric liver disease

We offer leading-edge treatment, including advanced surgical and medical options. Your child’s treatment will depend on their condition and symptoms.

Learn more about Doernbecher’s pediatric liver care.

We are the only program in Oregon to offer complete care for children with complex intestinal conditions. These conditions can lead to short-gut syndrome or intestinal failure.

What is intestinal rehabilitation?

Intestinal rehabilitation includes many treatments that can help the bowel work better. These include nutrition, feeding support, medication, surgery, and psychological support to improve the gut-brain connection.

How we treat intestinal disorders

Your child’s care team may include a gastroenterologist, GI psychologist, dietitian, feeding specialist, pharmacist, social worker, and pediatric surgeon. A nurse coordinator will help you:

  • Manage your child’s medications.
  • Learn more about their condition.
  • Schedule appointments with our team.
  • Work with your insurance carrier to get medicines and tests approved.

Children who have short-gut syndrome or intestinal failure can’t absorb enough nutrients from the food they eat. Malabsorption treatment can help replace some of the missing nutrients.

In rare cases, a bowel transplant may be needed. If your child needs a bowel transplant, we will work closely with a pediatric transplant center at another hospital in our region to get them the best care possible.

We are the only program in Oregon to offer complete care of eosinophilic esophagitis. Our approach includes nutritional and psychological support along with GI care.

What is eosinophilic esophagitis?

This auto-immune disease causes eosinophil (white blood cells) to build up in the esophagus. The build-up of white blood cells can make it hard to eat or swallow, and can damage the esophagus.

How we treat eosinophilic esophagitis

Your child’s gastroenterologist will first find the cause of their disease. This condition may be caused by food or other allergies, or acid reflux.

When we find the cause, we will bring together the right care team for your child. They may see a dietitian, feeding specialist, GI psychologist, or immunologist. Treatments include changes in diet, medication and dilating (stretching) the esophagus.

Most constipation is easy to treat at home or with your child’s primary care provider. Learn about treating constipation.

If your child has chronic or severe constipation, your pediatrician may refer you to our program for testing or treatment.

What is constipation?

Constipation is infrequent bowel movements or hard, dry stools that are hard to pass.

How we treat constipation

We offer testing to help find the underlying cause of your child’s constipation. We also care for children with constipation that is difficult to treat.

Our Integrative Health Program teaches your child about the gut-brain connection. This is the evidence-based link between the brain and digestive health. Your child’s Doernbecher gastroenterologist will refer you to our program if your child could benefit.

We care for children with disorders of gut-brain interaction (previously known as functional GI disorders). In these disorders, abnormal communication between the brain and gut causes long-lasting, uncomfortable GI symptoms. One common condition we treat is irritable bowel syndrome (IBS).

Symptoms we treat include:

  • Abdominal pain
  • Bloating
  • Reflux
  • Nausea
  • Feeling full quickly

These conditions are hard to treat with medication alone. Research has shown that learning to understand the brain-gut connection can help. Your child will see a gastroenterologist and a psychologist with expertise treating children with GI symptoms. We can help your child:

  • Learn to identify triggers for GI symptoms like pain or nausea
  • Learn to manage GI symptoms with effective, research-based strategies
  • Learn how stress, anxiety, sleep, exercise and nutrition affect gut health

Many children with GI conditions need changes to their diet as part of their treatment. Doernbecher dietitians will help create and manage the best nutrition plan for your child’s condition and preferences.

Some children with serious digestive conditions can’t eat enough food to fuel their body or can’t absorb enough nutrients from the food they eat. For these children, we offer:

  • Special diet plans: We may recommend your child eat or avoid certain foods. We may also recommend vitamin or enzyme therapy to add nutrients to your child’s diet.
  • Tube feeding: Feeding tubes help children who can’t eat enough food get the nutrients they need directly to their stomach or jejunum (middle of the small intestine). The most common type is the gastrostomy (G) tube that is placed through the abdominal wall into the stomach. Another common type, the gastro-jejunal (GJ) tube, extends through the stomach into the small intestine.
  • Parenteral nutrition: This is IV tube feeding. Feeding through the stomach or intestines is best, but when it is not possible this option is available. Your child’s care team will teach you how to feed them by IV tube at home. That means they don’t have to stay in the hospital to get the nutrients they need.

Children with GI conditions may benefit from working with a pediatric psychologist. This does not mean your child has a psychological disorder. Research shows that cognitive and behavioral strategies can help with managing a chronic disease or long-term GI symptoms.

We help children and families with:

  • Managing symptoms like abdominal pain and nausea
  • Coping with a chronic illness
  • Navigating school, friends, family, sports, and other activities when you have chronic GI symptoms

Our psychologists are experts in working with children with GI conditions. If your child is part of any of the treatment programs on this page, a pediatric GI psychologist may be on their care team. We also support children referred by one of our gastroenterologists.

Doernbecher’s Aerodigestive Clinic treats children with complex disorders that impact breathing and digestion such as aspiration, chronic cough and airway obstruction.

Doernbecher offers a complete approach to cystic fibrosis care, a disease that affects the lungs and digestive system.

Many GI diseases and conditions are lifelong. As your child becomes a young adult, we will support and prepare them to transition to an adult GI care team.

Your child won’t necessarily move to adult care the moment they turn 18. We consider their age, condition, preferences, and treatments that are underway, as we work with your family to make the transition.

We will empower your child to take responsibility for their health care as they enter adolescence and adulthood. We help them:

  • Feel comfortable talking independently with their providers
  • Know their medications, side effects, and personal medical history
  • Manage their medications and refill prescriptions
  • Understand medical bills and insurance plans
  • Feel secure managing their condition in new environments, like college or jobs.
  • Know what resources and tools are available to them
  • Choose their new care setting and share their health history with their new providers

We also support parents and caregivers with these challenges. We offer workshops for families to help them transfer healthcare responsibilities to their teens as they enter young adulthood.

GI tests and procedures

GI diseases and conditions have many symptoms in common. We may recommend specialized tests to help us find the cause of your child’s GI symptoms.

Common diagnostic tests include:

Colonoscopy: We place a thin tube with a camera at the end through the rectum. This test lets us look for inflammation and polyps in your child’s large intestine (colon). Your child will be asleep during the procedure.

A diagram illustrating a colonoscope inserted into the large intestine.

Endoscopy: We place a thin tube with a camera at the end through the nose or mouth. This test lets us see your child’s esophagus, stomach and duodenum. We can look for inflammation and test motility (movement processes). Your child will be asleep during the procedure.

A diagram illustrating a endoscopy inserted through the mouth and down into the stomach.

Capsule endoscopy: If we need to see your child’s small intestine or full digestive system, we may recommend this procedure. Your child swallows a capsule with a tiny camera inside. As it moves through their digestive system, it takes thousands of pictures.

pH/impedance probe: We place a thin tube through the mouth into the esophagus. A sensor on the end of the tube will measure how much stomach acid is leaving your child’s stomach.

Bravo esophageal pH test: During endoscopy, we place a wireless pH probe in the esophagus. Over the next few days, the probe will measure how much stomach acid is leaving your child’s stomach. The probe will naturally pass from your child’s body in a bowel movement.

Breath test: Your child will drink a special liquid and wear a nasal breathing tube. Over an hour, we will measure levels of certain gases or bacteria in their breath. This non-invasive test helps us diagnose lactose or fructose intolerance, or overgrowth of bacteria.

Anorectal manometry: We place a small tube with a balloon at the tip into the rectum. Sensors on the tube measure pressure and response of the anal sphincter and rectal muscles. This test helps us evaluate children with constipation or fecal incontinence.

Gastrostomy feeding tube (G-tube) placement: We place a thin tube with a camera at the end through the nose or mouth (endoscopy) to help guide the g-tube placement. We make a small cut in the left side of the abdomen and insert a flexible, hollow tube (the G-tube) into the stomach. Your child will be asleep during the procedure.

Gastro-jejunal feeding tube (GJ-tube) conversion: Most children with feeding tubes start with a G-tube. If your child still has symptoms like reflux or vomiting, we can replace the G-tube with a GJ-tube. This tube extends through the stomach into the jejunum (small intestine). The G-tube is removed and GJ-tube placed in the same procedure. Your child will be asleep throughout.

For families

Call 503-346-0640 to:

  • Request an appointment
  • Seek a second opinion
  • Ask a question

Locations

Parking is free for patients and their visitors.

Doernbecher Children’s Hospital
700 S.W. Campus Drive
Portland, OR 97239
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