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Dr. A. Jay Freeman with young boy patient in clinic

Pediatric gastroenterology is the branch of medicine that studies the digestive system and its diseases in children. The digestive system, also known as the gastrointestinal (GI) tract, includes the stomach, esophagus, small intestine, colon, rectum, pancreas, liver, gallbladder and bile ducts.

What is a pediatric gastroenterologist?

A pediatric gastroenterologist is a doctor who specializes in caring for children who have problems with their digestive systems or livers or are experiencing nutritional issues. Pediatric gastroenterologists have had additional years of training to care for infants, children and teens with GI disorders.

What is the difference between a gastroenterologist and hepatologist?

Hepatology is a subspecialty of gastroenterology. A pediatric hepatologist specializes in treating children with conditions of the liver, pancreas, gallbladder and biliary tree.

When should my child see a gastroenterologist?

If your child is experiencing bloody, painful, less frequent or foul-smelling stool, or if you notice bloody or persistent vomiting, you should call your child’s pediatrician. Your child’s pediatrician may suggest your child be seen by a pediatric gastroenterologist.

Children’s Healthcare of Atlanta is home to one of the leading pediatric gastroenterology, hepatology and nutrition programs in the country. We manage more than 3,150 inpatient and 41,000 outpatient gastroenterology visits each year. U.S. News & World Report has ranked our Gastroenterology and GI Surgery Program as one of the best in the nation.

Our specialized team combines expertise in pediatric gastroenterology, hepatology and nutrition with advanced diagnostic and therapeutic technologies to provide outstanding care to children with common and complex GI, liver and nutritional conditions. From inflammatory bowel disease (IBD) to gastroesophageal reflux disease (GERD) and nonalcoholic fatty liver disease, our team is here for your child.

In addition to exceptional clinical care, our doctors are active in the research community.

Our providers conduct multiple studies on the national level, making us unique in the Southeast. Children’s is the largest enroller of patients in ImproveCareNow, a national outcomes and quality registry for children with inflammatory bowel disease (IBD). To date, we have enrolled more than 1,300 children in the registry.

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At Children’s, our pediatric-trained doctors are skilled at diagnosing and treating children and teens with a wide range of GI, liver, pancreatic and nutritional disorders, from common to complex. Some of the most common digestive, GI and liver conditions in kids include:

Our team cares for children and teens with general gastroenterology conditions, including:

  • Abdominal pain
  • Celiac disease
  • Clostridium difficile (C. diff)
  • Complex nutritional problems
  • Congenital metabolism problems
  • Diarrhea and constipation
  • Eating disorders
  • Eosinophilic esophagitis
  • Feeding difficulties and tube feed management (ex. G-tube)
  • Food allergies that affect the GI tract
  • Gastroenteritis
  • Gastroesophageal reflux disease (GERD)
  • GI bleeding
  • Helicobacter pylori infection
  • Hirschsprung’s disease
  • Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis
  • Pancreatitis (acute and chronic)
  • Poor growth
  • Reflux
  • Vomiting

Through our Liver Disease Program, the Children’s team of pediatric hepatologists treat a variety of liver-related diseases and complications, including:

  • Acute liver failure
  • Autoimmune hepatitis
  • Biliary atresia
  • Chronic viral hepatitis
  • Cystic fibrosis-associated liver disease
  • Elevated liver enzymes (ALT and AST)
  • Liver transplantation evaluation and management
  • Liver tumors
  • Neonatal cholestasis
  • Nonalcoholic fatty liver disease
  • Portal hypertension
  • Primary sclerosing cholangitis
  • Prolonged neonatal jaundice
  • Rare metabolic diseases
  • Wilson’s disease

Our nutrition team is equipped to treat many conditions, including:

  • Dyslipidemias
  • Hypertension
  • Nonalcoholic fatty liver disease
  • Obesity

In the Children’s Aerodigestive Clinic, our pediatric gastroenterologists work closely with other specialists, including otolaryngologists, pulmonologists, voice disorder specialists, nutritionists and speech-language pathologists to provide comprehensive care to children with a combination of conditions, including:

  • Asthma
  • Chronic cough with or without reflux or laryngopharyngeal disease
  • Feeding problems associated with oropharyngeal dysfunction with or without reflux and respiratory problems
  • Hoarseness, noninfectious pharyngitis, or laryngitis with or without respiratory issues
  • Laryngopharyngeal diseases with coexisting esophageal and respiratory issues
  • Recurrent aspiration or pneumonia with reflux or laryngopharyngeal issues
  • Reflux and gastroesophageal reflux disease

For infants and children with short bowel syndrome and intestinal failure who receive parenteral nutrition, we offer a full spectrum of services through our Intestinal Rehabilitation Program.

The Children’s Intestinal Rehabilitation Program has a team of experts, including pediatric gastroenterologists, general surgeons, a registered dietitian, speech-language pathologists, nurse coordinators and a social worker. The goal is for children to achieve complete enteral independence from parenteral nutrition and to avoid transplant, using medical, surgical and nutritional rehabilitation strategies.

Our Advanced Pancreatic Care Program assists in treating children with a variety of pancreatic diseases, ranging from acute pancreatitis to rare genetic disorders and congenital malformations.

The Children’s Advanced Pancreatic Care Program has a multidisciplinary approach that includes expertise in pediatric pancreatic care, from a gastroenterologist specializing in pediatric pancreatology and pediatric surgery, to an advanced endoscopist with expertise in endoscopic retrograde cholangiopancreatography (ERCP), as well as a pain specialist, endocrinologist and dietitians.

Different procedures may be performed to help us determine the right diagnosis and develop the best treatment plan for your child. Your child may have one or more of the following procedures:

  • Colonoscopy: A colonoscopy is a test that examines the large intestine by inserting a long, flexible, lighted tube called a colonoscope into the rectum.
  • Endoscopy: This procedure uses an endoscope, which is a lighted, flexible instrument containing a computer chip and camera that is attached to a TV monitor, to examine the upper or lower GI tract.
  • Capsule endoscopy: A capsule endoscopy uses a pill-sized video camera that is swallowed to allow a doctor to examine the middle part of the GI tract.
  • Upper endoscopy: An upper endoscopy is a procedure that allows the doctor to see the esophagus (food tube), stomach and the first part of the small intestine with an endoscope.
  • Bravo pH testing: The Bravo pH Monitoring System measures pH to test for GERD in older children. The doctor implants a small, temporary device on the wall of your child’s esophagus during an endoscopy. The device collects data about acid levels.
  • pH probe study: A pH probe study measures the acid levels inside of the esophagus to test for GERD in younger children. The doctor inserts a thin probe through the nose and into your child’s esophagus to record acid levels.
  • Manometry: A manometry is a test that examines how rectal muscles and nerves are working. The test helps determine the cause of anorectal constipation or encopresis (stool leakage). The doctor inserts a thin, flexible tube called a catheter into the rectum to record pressure. A small balloon attached to the tube may be inflated to assess reflexes.

Some of the additional services, treatments and procedures we offer include:

  • Anorectal manometry
  • Biologic medicine infusions
  • Breath hydrogen analysis
  • Endoscopic retrograde cholangiopancreatogram (ERCP)
  • Esophageal band ligation
  • Esophageal manometry/impedance-pH monitoring
  • Esophagogastroduodenoscopy (EGD)
  • Nutrition support services
  • Percutaneous gastrostomy tube placement
  • Sigmoidoscopy
  • Video capsule endoscopy (VCE)

What is ERCP?

Endoscopic retrograde cholangiopancreatography (ERCP) is a specialized procedure that combines X-ray and the use of an endoscope to help our doctors access parts of a child’s pancreas and liver. Oftentimes, ERCP can prevent a child from undergoing an invasive surgery. This procedure helps treat conditions, such as:

  • Jaundice
  • Gall stones and bile stones
  • Biliary and pancreatic duct abnormalities
  • Pancreatitis
  • Complications from a liver transplant and liver disease

At Children’s, we embrace collaboration among our pediatric specialists. Through this collaboration, we offer many multidisciplinary programs and clinics in which our gastroenterologists, hepatologists and nutritionists participate. In fact, we offer the most specialized programs in the Southeast.

  • Advanced Pancreatic Care Program: We treat a variety of pancreatic disease cases ranging from acute pancreatitis to rare pancreatic tumors.
  • Aerodigestive Clinic: Our team is dedicated to finding the right answers and treatments for children with complex airway and digestive tract disorders.
  • Eosinophilic esophagitis (EoE) and gastroenteritis: We offer consultations from a gastroenterologist, allergist and nutritionist for children with gastroenteritis, EoE and food allergies that affect the GI tract.
  • Fecal Microbiota Transplant Program: This type of transplant involves transferring a healthy donor’s stool into a recipient’s digestive system to eliminate “bad” bacteria, such as C. diff.
  • Feeding Program: We help children with chronic and severe disruptions in their relationship with food.
  • Intestinal Rehabilitation Program: We provide comprehensive care—from medical to nutritional to surgical management—to children with intestinal failure and short bowel syndrome.
  • Liver Disease Program: We treat a variety of liver-related conditions and complications in children.
  • Neurogastroenterology and Motility Program: We create highly specialized treatment plans for children who have digestion issues due to problems related to contractions in the gastric muscles.
  • Pelvic and Anorectal Care Program: Our team cares for children with surgical diseases resulting in constipation, diarrhea, soiling and/or pain as a consequence of the disease.
  • Strong4Life Clinic: Our team provides a holistic approach to obesity and weight-related conditions.

Our Gastroenterology, Hepatology and Nutrition Program is comprised of Children’s Physician Group providers and pediatric gastroenterologists in the community. This team of specialists works together to help ensure complete, coordinated care is delivered seamlessly at our hospitals for children and teens with GI and liver conditions. 

Physician leadership

The following physicians lead our Gastroenterology, Hepatology and Nutrition Program:

Children's Physician Group–Gastroenterology, Hepatology and Nutrition

Children's Physician Group is the largest pediatric multispecialty physician practice in Georgia with more than 500 doctors and 400 advanced practice providers who are employed by Children’s or serve as faculty members at Emory University School of Medicine. Children’s Physician Group–Gastroenterology, Hepatology and Nutrition providers include:

Gastroenterologists

Hepatologists

Advanced endoscopist

Advanced practice providers

  • Michelle Dinser, CPNP
  • Chris Fritzen, PA
  • Kristine Lowe, PA

Psychologists

  • Bonney Reed, PhD, Gastroenterology
  • Jessica Buzenski, PhD, Gastroenterology
  • Gloria Chiang, PhD, Hepatology

Private practice gastroenterologists in our program

We work closely with the following private practice physicians in our program to lead research, develop specialized programs and deliver seamless care to patients at our hospitals.

Children’s Physician Group–Gastroenterology, Hepatology and Nutrition offers outpatient GI and hepatology clinics in locations across metro Atlanta. ERCP and other procedures, like endoscopy, are performed at our hospitals.