Department of Pediatric Gastroenterology in Israel

The Pediatric Gastroenterology Department at Tel Aviv Medical Clinic provides comprehensive diagnostic services and modern treatment methods for digestive system diseases in children, both in inpatient and outpatient settings. The course of gastrointestinal (GI) diseases in children, their symptoms, and treatment methods differ significantly from those in adults. Therefore, the medical staff working with children undergoes specialized training and internships at the world’s leading pediatric hospitals.

A multidisciplinary team, including pediatric gastroenterologists, surgeons, endoscopists, radiologists, dietitians, and other specialists, collaborates closely to develop effective individualized treatment programs for each child. Additionally, the pediatric gastroenterology department doctors and their patients actively participate in clinical trials in Israel and abroad. In some cases, this presents a real opportunity to completely eliminate painful symptoms and the disease causing them.

Key Advantages of Treatment at the TAMC Pediatric Gastroenterology Department:

• Specialized approach to treating children. All invasive procedures involving pain or fear are performed under general anesthesia (medicated sleep). This prevents pain, fear, or psychological discomfort for the child.
• High-precision and rapid comprehensive diagnostics. Diagnostic programs developed by Israeli gastroenterologists and modern endoscopic equipment allow for the precise identification of a child’s complaints and their effective resolution.
• Child-friendly environment in the department. Most of the medical staff working with children have special psychological training, enabling them to find an individual approach to each young patient.

The Pediatric Gastroenterology Department includes several subdivisions and specialized clinics operating simultaneously. This approach enhances medical care effectiveness, as each specialist focuses on studying, diagnosing, and treating specific gastroenterological issues, ensuring an in-depth understanding of managing particular patient groups.

• General Gastroenterology – Typically, this is outpatient gastroenterology. Specialists in this area handle common digestive system diseases, primarily using conservative treatment. If a patient’s case requires specialized care, the outpatient gastroenterologist refers them for comprehensive diagnostics and to another specialist depending on the diagnosis.
• Inflammatory Bowel Disease Clinic – Specialists here diagnose and treat chronic inflammatory bowel diseases, including ulcerative colitis, Crohn’s disease, and other undifferentiated colitis and enteritis.
• Endoscopy Service – This unit performs all types of modern endoscopic examinations and therapeutic endoscopic interventions, such as esophagogastroduodenoscopy (EGD), colonoscopy, video capsule endoscopy, gastrointestinal bleeding control, gastric and intestinal biopsy, among others. The department uses specialized endoscopic equipment that is significantly thinner than standard devices, making the examination more comfortable and safer for children.
• Liver Disease Clinic – Hepatologists diagnose and provide comprehensive treatment for liver diseases in children, including infectious hepatitis, hemochromatosis, fibrosis and cirrhosis, as well as benign and malignant liver tumors.
• Clinical Dietetics – Specialists in this field help create appropriate nutrition plans for various diseases, childhood obesity, and weight deficiency.
• Pancreatic and Biliary Pathology Clinic – Specialists assist young patients with pancreatic diseases, gallbladder conditions, and bile duct disorders.
• Esophageal, Gastric, and Duodenal Pathology Clinic – Gastroenterologists here specialize in diseases of the esophagus, stomach, and duodenum.

Conditions Treated by the Pediatric Gastroenterology Department:

• Pediatric Intestinal Obstruction
• Crohn’s Disease in Children

Diagnostic Methods in Pediatric Gastroenterology

Children at the TAMC Pediatric Gastroenterology Department can undergo all necessary diagnostic tests. The diagnostic stage typically lasts 1-3 days, depending on the examination program prescribed by the treating physician.

• Esophagogastroduodenoscopy (EGD) – An endoscopic method for examining the esophagus, stomach, and duodenum. TAMC endoscopists use modern flexible endoscopes that are much thinner than standard ones, making the procedure safer and easier for children. If needed, additional procedures like mucosal biopsy or bleeding control can be performed during the examination. The procedure is conducted under general anesthesia to eliminate pain and fear.
• Fibrocolonoscopy – An endoscopic examination of the rectum and colon. As with EGD, this procedure uses flexible, thin endoscopes and is performed under medicated sleep to ensure patient comfort. If necessary, targeted biopsy or therapeutic procedures such as polyp removal or bleeding control can be performed.
• Video Capsule Endoscopy – An advanced diagnostic method for assessing the entire GI tract, from the oral cavity to the rectum. The primary advantage of this method is the ability to examine the small intestine, which is inaccessible to both EGD and colonoscopy. Additionally, the procedure is completely painless and does not require anesthesia. During the examination, the child swallows a small video capsule that captures images or videos of the mucosa while passing through the GI tract and is naturally expelled through defecation.
• Abdominal Ultrasound (US) – A valuable, accessible, safe, and non-invasive method for assessing digestive organs. Using expert-class ultrasound machines, TAMC specialists accurately diagnose and prescribe effective treatments. Ultrasound can evaluate the liver, gallbladder, pancreas, spleen, stomach, and intestines.
• Modern medical imaging techniques allow for a detailed study of pathological processes, their localization, and extent. For this purpose, CT, MSCT, MRI, and PET-CT may be used. One example is virtual colonoscopy, a type of multislice computed tomography (MSCT), which is a non-invasive alternative to standard colonoscopy in cases where invasive procedures are contraindicated.
• Endoscopic Retrograde Cholangiopancreatography (ERCP) – An endoscopic method for examining the bile ducts, also used for therapeutic interventions such as stone removal or dilation of narrowed bile ducts.
• Liver Biopsy – Considered the “gold standard” for diagnosing liver diseases. This complex and delicate procedure is performed by experienced specialists in an operating room setting. TAMC also offers non-invasive liver biopsy alternatives such as FibroScan or FibroMax, which estimate the degree of fibrosis using specialized biochemical markers, eliminating the need for a needle biopsy in some cases.
• Gastrointestinal X-ray examinations remain relevant and are performed using modern digital radiography devices, often incorporating barium contrast imaging.
• Diagnostic Laparoscopy – Used when the cause of abdominal pain remains unidentified after initial tests. If needed, diagnostic laparoscopy can immediately transition to therapeutic intervention (e.g., laparoscopic appendectomy in cases of appendicitis).
• Molecular Genetic Testing – This advanced diagnostic tool is frequently used for identifying hereditary GI diseases, such as Wilson’s disease (copper accumulation in the liver causing cirrhosis), hereditary hemochromatosis (iron overload in the liver and other organs), cystic fibrosis, celiac disease, and lactose intolerance.

Modern Treatment Methods in Pediatric Gastroenterology

The Pediatric Gastroenterology Department at Tel Aviv Medical Center offers a full range of conservative and surgical treatments for gastrointestinal diseases in children. In addition to traditional drug therapy, dietary therapy, and surgical interventions, our specialists actively use innovative minimally invasive procedures to treat children with digestive system disorders.

Gastric Pacemaker Implantation for Pediatric Gastroparesis

Gastroparesis is a condition in which the stomach’s motility is impaired, causing food to remain in the stomach for extended periods instead of moving through the digestive tract. At our department, we use a unique treatment approach for this disorder. A gastric pacemaker is implanted into the abdominal wall, with electrodes attached to the stomach. The device generates electrical impulses, helping the stomach empty at the appropriate time.

Biologic Therapy for Inflammatory Bowel Diseases (IBD)

In Israel, biologic drugs are actively used to treat children with Crohn’s disease and ulcerative colitis. Advanced immune-biological therapies, such as Remicade and Humira, are commonly prescribed. These biologic medications effectively reduce inflammation, particularly in cases where conventional therapy proves ineffective. In many cases, biologic therapy prevents the need for extensive intestinal surgery.

Botulinum Toxin Treatment for Chronic Anal Fissures

Botulinum toxin injections offer a minimally invasive solution for treating chronic anal fissures. The injection relaxes the anal sphincter, allowing the fissure to heal completely. The procedure takes approximately five minutes and is performed on an outpatient basis.

Balloon Dilation for Esophageal Strictures

This procedure helps eliminate esophageal strictures (narrowing of the esophagus), which may be congenital or acquired (e.g., following chemical burns of the esophagus). The procedure is performed endoscopically under general anesthesia. A special balloon catheter is inserted into the esophagus in a collapsed state. Once positioned correctly, the balloon is inflated, thereby expanding the narrowed esophageal passage.

These are just some of the advanced treatment methods successfully used by specialists at the Pediatric Gastroenterology Department at Tel Aviv Medical Clinic. If your child has a digestive system disorder, seek help from the leading pediatric gastroenterologists at TAMC.