Our Gastroenterology & Nutrition Center provides a multi-disciplinary and multispecialty approach for consultation, diagnostic testing and medical management of children with liver, nutritional, and gastrointestinal conditions. Children ages birth through 21 years of age, who are treated for conditions involving the stomach, esophagus, small intestine and large intestine (colon), liver, gallbladder and pancreas receive a comprehensive care plan that manages their symptoms from diagnosis to treatment by a specialized care team, often working closely with other pediatric sub-specialists.

Gastroenterologists perform procedures such as liver biopsies and endoscopic "scope" examinations of the esophagus, stomach, small and large bowel. Some common tests performed include, stool tests, blood tests, upper GI series or various radiology exams and endoscopic “scope” procedures to help diagnose and treat various stomach and gastrointestinal conditions.

GI Lab & Motility Program

We offer a gastrointestinal lab and motility program that cares for patients and their families with timely and reliable diagnostic studies, treatment planning and education. In the lab and motility program, we treat and care for neonates, infants, pediatric and adolescent patients. The most common diagnosis is gastroesophageal reflux.

Designated CCS Center

Our Gastroenterology & Nutrition Center is a California Children’s Services (CCS) approved Special Care Center (SCC) for gastrointestinal disorders. This means a specially designated multi-disciplinary care team is responsible for all care coordination and case management of a patient in this program. Patients typically qualify for the Gastrointestinal CCS Special Care Center by medical diagnosis, complexity of their disease and financial status.

Why You Should Choose Miller Children’s & Women’s

  • We have an Inflammatory Bowel Disease (IBD) Program dedicated to the management of Crohn’s disease and ulcerative colitis in children and teens. The program brings together a wide range of care specialists to support the child and family in managing their individual needs.
  • We are part of the ImproveCareNow network, an international, multi-center collaborative network that is transforming care and improving outcomes for children, adolescents and young adults with IBD.
  • Our pediatric gastroenterologists work closely with our Cystic Fibrosis Center – one of the largest in the U.S. – in the comprehensive care for cystic fibrosis patients who have lung and GI ailments.
  • We’re one of a few hospitals in the area to use the Bravo Implantable pH Probe, the world’s first catheter-free Intraesophageal pH probe pH test. Bravo provides a more comfortable and convenient way to evaluate reflux and heartburn symptoms when compared to catheter-based pH monitoring systems.
  • We’re one of the few hospitals on the West Coast that performs impedance studies. These tests are done to find out if the contents of the stomach are coming up into the esophagus or food tube.

Procedures and Tests

We have a Sedation/Procedure Room, with full anesthetizing and monitoring capabilities outside of the main operating room suite, giving physicians and families easy access to their child. The room is appropriate for procedures that could be performed in a doctor's office/procedure room if deep sedation or general anesthesia were not needed. These procedures may be required as part of the diagnostic work-up or treatment. 

To prevent discomfort to a child, most scope tests for GI conditions are done under general anesthesia, using intravenous sedation and require special preparation. The patient and family-centered care team will explain any special preparation that will be necessary during the procedure to the patient and their family.

We’re a regional leader in the following procedures and tests:

Colonoscopy

Colonoscopy is a procedure used to see the inside of the colon (the large intestine and the last part of your digestive system) and rectum. A colonoscopy can detect inflamed tissue, ulcers and
abnormal growths.

  • To prepare for this procedure, patients need to clean out their system. A laxative or an enema may be suggested to aid in clean out.
  • On the night before the procedure, children cannot eat after midnight and through the morning of the scheduled procedure.
Esophagogastroduodenoscopy (EGD)

EGD is a procedure for upper gastrointestinal ailments, such as reflux, esophagitis, gastritis and ulcer disease.

  • EGD is an examination of the lining of the esophagus, stomach, and upper duodenum (the first part of the small intestine) with an endoscope (a lighted, flexible tube), which is inserted down the throat.
  • After the patient is given an IV and is sedated (either moderate or deep sedation) the doctor will pass the tube through the mouth and back of the throat into the esophagus, stomach and duodenum and a picture or a video will be taken.
  • The EGD procedure checks for ulcers and other abnormalities the patient may have. If necessary, an instrument can be passed through the tube to take a small piece of tissue (a biopsy) for examination in the laboratory.
Impedance Studies

We’re one of only a handful of hospitals to participate in these studies on the West Coast. Impedance studies are tests that are done to find out if contents from the stomach are coming up into the esophagus or food tube. It helps evaluate acid and non-acid gastroesophageal reflux. Most of these procedures require an overnight stay.

  • During this test, a thin, flexible tube is passed through the nose, down through the back of the throat, and into the esophagus.
  • The end of the tube is attached to a computer which will remain at the child's bedside throughout the study. The child will need to stay overnight in the hospital, to ensure that the computer can record the necessary data.
  • The study takes approximately 18 to 24 hours and the tube is left in place during this time.
  • Parents will be asked to keep a diary of their child's activity during the impedance study and the doctor will then use the diary to compare the computer reading with the child's activity. When going through this test parents are encouraged to bring books, small toys, videos or other items to occupy the child while he or she is in bed.
Intraesophageal pH Probe

We use the Bravo Implantable pH Probe to do the world’s only catheter-free intraesophageal pH probe test. The test uses a probe to measure the pH (acidity) levels in the esophagus. These measurements allow the doctor to evaluate the patient’s heartburn and acid reflux symptoms and plan the best treatment for the patient’s diagnosis.

The Bravo System has the potential to provide a more accurate picture of acid exposure compared to data collected using catheter-based systems. Another positive aspect of this leading test is the patient is allowed to do normal activities during the pH test, and doesn’t have to go through the discomfort of having a catheter put in.

  • The probe is at the end of a thin tube which is passed through one side of the nose, swallowed and is moved to a given location in the bottom of the esophagus.
  • The patient then goes home and the Bravo Receiver takes continuous pH measurements and transmits information wirelessly to a small receiver the patient wears on his or her waistband. The number of GE reflux (backwashing of acid into the esophagus) episodes and length of each episode is recorded by the device attached to the probe.
  • Most importantly, the catheter-free test allows the patient to engage in his or her normal activities. Patients can eat normally and engage in their normal activities during the test.
  • The patient or patient’s parents/caretakers should keep a diary of any symptoms and the times that they occur.
  • The probe is usually worn for 18 to 24 hours so that there is ample opportunity to detect both daytime and nighttime GE reflux episodes.
  • After the study, information from the receiver is uploaded to a computer for analysis.
Hepatology Procedures
  • Liver biopsy is a procedure where small pieces of liver tissue are removed and tested to diagnose any diseases that affect the liver.
  • Gallbladder removal is a procedure done in general surgery when someone has gallstones or if the gallbladder is not functioning properly. This is when the doctor may recommend gallbladder removal surgery. Our hepatologists work side-by-side with our general surgeons to complete this procedure and get patients back on track. Our surgeons can perform this surgery using minimally invasive surgery, to decrease scarring, minimize pain and shorten hospital stays — often only taking about one hour to complete.

Your Care Team

We have a team of board-certified pediatric gastroenterologists that covers specialty and supportive care. These experts provide a full-range of pediatric gastroenterology care, from diagnosis, treatment, surgical care and post-procedure and follow-up care.

Meet Our Physicians

Other Team Members

Meet Our Care Team

Registered Nurse Specialists
The registered nurse specialist provides communication among the child, family, primary care physician, neurology team and others involved in the care of the child. The nurse also provides any authorizations and medical information to any other care centers that will be caring for the patient. The nurse specialist also will educate all those involved in the child’s care.

Clinical Social Workers
Social workers help provide referrals to a broad range of community-based agencies and organizations to assist the child and family in obtaining supportive care and assistance. The social worker also is available to provide crisis counseling, individual and family counseling.

Registered Dietitians
Registered dietitians assess patients’ nutritional needs, develop and implement nutrition programs, and evaluate and report the results. They also confer with doctors and other health care professionals to coordinate medical and nutritional needs.

Child Life Specialists or Assistants
Child life specialists or assistants can help your child better understand his or her condition and treatment while making him or her feel more comfortable during their stay or visit to the hospital. 

Locations

Surgical Center