Stomach conditions (gastroenterology)

 

Children and Young People's Gastroenterology Service

Gastroenterology is an area of medicine that focuses on the health of the digestive system or the gut.

We provide a specialist service for children and young people with gastrointestinal problems, such as inflammatory bowel disease and coeliac disease. We also look after children who have problems with their liver or nutrition.

We provide services for young people up until their 18th birthday. Young people aged 16 or 17 years can choose to be looked after by adult services, if they prefer. We also offer a transition service for young people with inflammatory bowel disease.

More on what we do

We can offer tests and examinations for children and young people locally in Exeter, including endoscopy and MRI scanning. Endoscopy is usually done under general anaesthetic as a day case procedure.

We have strong links with the adult gastroenterology and nutrition service at the RD&E and our local Specialist Paediatric Hospitals (Bristol Children's Hospital for gut problems and Birmingham Children's Hospital for liver problems).

We have a nutrition team who can help with tube feeding (gastrostomy or nasogastric tube) and parental nutrition (intravenous food). Our local nutrition team can insert gastrostomies endoscopically but younger children need to go to Bristol for this procedure.

We work closely with our Paediatric Research Team, so please ask us if you are keen to be involved in any studies we have running.

Treatments

We manage a wide range of conditions. We have the capacity on our Bramble Day Case unit to give infusions such as iron or biologic medicines. We also support young people and families to have greater autonomy for their conditions and teach them how to give certain injected medication at home.

We have a team dieticians who provide advice and guidance for a wide range of specific dietary needs.

Our team

Consultant paediatricians with an interest in gastroenterology

  • Dr Christine McMillan
  • Dr James Hart

Consultant adult gastroenterologists providing endoscopy services

  • Dr Tariq Ahmad
  • Dr Tawfique Daneshmend

Inflammatory bowel disease nurse

  • Michelle Clark

Lead dietitian

  • Susie Costelloe

Where to find us

RD&E Wonford, Barrack Rd, Exeter EX2 5DW

Bramble Ward, Area H. 

Contact us

If you want to get in touch with the department, please contact:

Secretary for Dr James Hart: 01392 406148 or 402629

Secretary for Dr Christine McMillan: 01392 402676

Bramble Day Case Unit: 01392 402677

Paediatric Dieticians: 01392 206063

Inflammatory bowel disease help desk: 01392 402728

Community services

We work closely with the Bladder and Bowel Care nurses at Integrated Children's Services, who provide services for children with constipation and faecal incontinence.

Clinics

All our clinics are currently conducted from the Children's outpatient department, area J, at the Wonford Hospital site. 

  • Paediatric Gastroenterology clinic (Dr Hart and Dr McMillan).
  • Coeliac clinic (this is a joint clinic with a paediatric dietitian and either Dr Hart or Dr McMillan).
  • Inflammatory bowel disease transition clinic, for young people preparing to move to adult services (Dr Tariq Ahmad and Dr Hart or Dr McMillan).
  • Gastroenterology Clinic with visiting Bristol specialist (Dr Tony Wiskin and Dr Hart or Dr McMillan).

Information for healthcare professionals

Please refer to the Joint Formulary for condition specific advice. Please include recent weight and height in referral letter.

The below list is for quick reference and not an exhaustive list of all conditions. Please contact us for advice and guidance if unsure of who to refer to.

Suspected inflammatory bowel disease

  • Refer urgently via e-Referrals to paediatric gastroenterology, FAO Dr James Hart or Dr Christine McMillan.

Patients with positive coeliac serology

  • Should not be started on a gluten free diet until the diagnosis is confirmed in secondary care.
  • Refer urgently via e-Referrals to paediatric gastroenterology, FAO Dr James Hart or Dr Christine McMillan.

Chronic abdominal pain and irritable bowel syndrome

  • Ideally should be managed in primary care. See Joint Formulary for guidance on management and red flags.
  • Consider referral to general paediatrics if school attendance is less than 85% despite management in primary care.

Constipation

  • Refer to Paediatric Bladder and Bowel Care nurses, Franklyn House.
  • If red flags (see NICE guidance) refer via e-Referrals to paediatric gastroenterology, FAO Dr James Hart or Dr Christine McMillan.

Reflux or non-specific GI symptoms

  • If requires secondary care referral please refer to general paediatrics rather than Paediatric Gastroenterology

Children already under the care of a paediatrician should be referred back to the same paediatrician.

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