We provide outpatient and inpatient consultation and care for infants, children and adolescents with common as well as complex gastrointestinal, liver and nutritional disorders.
Gastroenterology Clinic
Some of the gastroenterological conditions which we evaluate and treat include datively simple disorders including:
- Gastroeosphageal reflux
- Recurrent abdominal pain
- Vomiting
- Constipation and soiling
- Diarrhoea
- Food intolerance
- Failure to thrive
as well as more complex disorders such as
- Chronic liver disease
- Hepatitis
- Inflammatory bowel disease
- Malabsorption
- End stage liver failure
Combined Hepatobiliary Clinic
The purpose of this clinic is to review children with a variety of liver disorders. There is a special emphasis on those children who would require liver transplantation.
Children post-liver transplant are also seen periodically at this clinic in addition to their regular check-ups with the paediatric gastroenterologist.
The members of this multi-disciplinary team include the paediatric surgeons, transplant surgeons, dietician, medical social worker and transplant co-ordinators.
Liver Transplantation
The Singapore Paediatric Liver Transplant Programme is based here at The University Children's Medical Institute. This programme involves the evaluation and management of children with end-stage liver disease prior to transplantation, as well as their post-operative care following transplantation.
A multidisciplinary team consisting of paediatric gastroenterologists, paediatric surgeons, liver transplant surgeons, radiologists, histopathologists, psychiatrists, physiotherapists, dietician, social worker and transplant co-ordinators are involved in the specialised care of these children.
Our Special Services
24-hour Oesophageal pH Monitoring
Monitoring pH in the distal oesophagus is an accurate method of evaluating acid reflux events over time, thereby determining if gastroesophageal reflux is present. This is especially useful in the child with atypical symptoms such as recurrent coughing, wheezing, chest discomfort and failure to gain weight.
In addition, not only can it clarify the relationship between reflux episodes and the non-GI symptoms, but also to check response to therapy in situations where the non-GI symptoms are the primary complaint.
What the study entails is the insertion of a special probe via a naso-gastric route, into the stomach. The distal end of the probe contains 2 pH electrodes, one of which would be placed in the lower oesophagus and the other in the stomach. The electrodes are connected to an external pH recorder where the output is stored for later printout. The study is performed on an in-patient basis, and children are encouraged to consume a similar diet that they normally would at home.
Endoscopy
An endoscope is a flexible tube with its own lens and light source. It can be passed through the mouth, or through the anus, such that the upper gastrointestinal tract or lower gastrointestinal tract can be studied respectively. Endoscopy is both a useful diagnostic as well as therapeutic tool.
It can be used in the investigation of children with a variety of gastrointestinal complaints such as recurrent abdominal pain, suspected H pylori infection, gastrointestinal bleeding and malabsorption.
Paediatric gastrointestinal endoscopy is performed in the hospital endoscopy suite, and can be done either on an in-patient or out-patient basis. Intravenous sedation is used for paediatric endoscopy.
Percutaneous Endoscopic Gastrostomy (PEG) Insertion
This procedure involves the insertion of a feeding tube into the stomach (gastrostomy) with the help of an endoscope. It is both a safe and rapid technique for the insertion of a special feeding tube for children with difficulties in swallowing or those who require an increased food intake. It can be performed using intravenous sedation or under general anaesthesia, depending on the clinical status of the child.
Liver Biopsy
This is a procedure whereby a tiny piece of liver tissue is removed for microscopic examination. It is usually performed percutaneously under intravenous sedation. The child would require a period of close observation before being discharged after the procedure.
Biopsies are usually performed when there is a need to clarify the cause of liver disease present in a child, whereby other measures have failed to do so.
