November 5, 2009
SIU GI Specialist Treats Various Pediatric Conditions
A tummy ache is a common complaint of children age five through the teen years, which often brings them to their doctor’s office. Children’s stomach aches can be caused by a number of medical and psychological conditions, says Dr. Terry Hatch, professor and division chief of pediatric gastroenterology and nutrition at Southern Illinois University School of Medicine in Springfield.
As a pediatric gastroenterologist, Hatch treats a variety of medical conditions involving the esophagus, stomach, bowel, pancreas, liver and gallbladder. A member of St. John’s Children’s Hospital (SJCH), he also sees patients, infants through teens, who have nutritional problems and feeding and eating disorders.
“A child’s tummy ache can be caused by an ulcer, heartburn, gastroesophageal reflux disease (GERD), intestinal or psychosocial problems,” says Hatch. Often the condition is not caused by a medical condition that parents suspect, but those children have chronic pain syndrome. In these cases, in addition to treating the cause of the problem such as an ulcer or GERD, an additional treatment, such as cognitive therapies, is required for the chronic pain.
Children of any age, even very young infants, can suffer from normal gastroesophageal reflux problems, which occur when stomach contents go back into the tube that connects the mouth to the stomach. This reflux often occurs normally in infants – they are happy and healthy even though they spit up or vomit.
“Spitting up in infants tends to peak by age four months and most of them stop spitting by 12 to 18 months of age,” explains Hatch.
Many older children experience traditional gasteroesophageal reflux disease (GERD), in which they have excessive regurgitation. GERD can be treated in a variety of ways, including lifestyle modification and diet or medications to inhibit acid production. The incidences of GERD increase with age and are more prevalent in children who are overweight.
Other common problems Hatch sees in his practice include complaints of poor growth or failure to thrive, feeding difficulties, disorders involving vomiting or swallowing problems as well as diarrhea and constipation. Hatch works with patients and their parents to get a complete medical history, a physical exam and other diagnostic studies if needed.
Hatch and his colleagues treat feeding and eating disorders from early childhood through young adulthood. In infancy, feeding disorders may be involved with a child’s premature birth and various medical interventions and problems as well as neurologic disorders.
In toddlers and children, his patients have a broad range of eating problems, including small appetites and a very narrow selection of foods that they will eat. Parents are often worried that their children may be malnourished because they aren’t eating a well-rounded diet. The introduction of new foods to children’s diets can be challenging for parents. He usually recommends introducing solids in the middle of a child’s first year and then adding a reasonable array of solids over the next six to eight months.
“Eating is an intensely social/psychological behavior and eating problems can arise in a troubled family or difficult personal circumstances,” says Hatch. He advises parents that meal times should be a pleasant time of day when family members relax, enjoy, celebrate and hopefully eat more generously and more healthily. “It is not a time to get even, invoke behavior interventions or discuss serious problems,” he says.
Hatch uses a multidisciplinary feeding team to help patients and parents in helping correct children’s feeding and eating disorders. The team includes Hatch and his colleague, Dr. Samer Ammar, assistant professor of pediatrics, along with a dietitian, psychologist, nurse and speech therapist.
Obesity is another problem which brings many children to see their physicians. “Treating obesity is very difficult because treatments are not very effective,” says Hatch. Medical treatment involves counseling, behavioral interventions and diet. He says bariatric surgery is now being performed on patients in their early and mid-teens with good outcomes.
Hatch says the best way to deal with obesity is prevention, which requires the co-operation of the entire family and community including schools. He recommends eating a healthy diet and getting regular exercise to keep the excess pounds off and suggests following the U.S. Department of Agriculture food pyramid found online at www.mypyramid.gov. He warns against excessive consumption of sweetened beverages and encourages active play for children and family activities that include exercise.
Hatch says his pediatric division is increasing collaboration with physicians in SIU’s Internal Medicine Department regarding medical care issues as well as research activities.
Hatch joined SIU in 2009 after 30-plus years in medical practice in Champaign and teaching at the College of Medicine at the University of Illinois Urbana-Champaign. He is board certified in pediatrics and pediatric gastroenterology by the American Board of Pediatrics.
SIU School of Medicine’s mission is to assist the people of central and southern Illinois in meeting their health needs through education, service, research and community service. The School has more than 220 full-time physicians as well as other medical professionals, offering both primary care and specialized treatment services. The medical school works in partnership with hospitals and clinics throughout Illinois. Clinical outreach efforts extend SIU’s involvement to 50 Illinois communities. For information, call SIU’s Call Center, 217-545-8000 or 1-800-342-5748. Its Web site is www.siumed.edu.
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