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Diagnostic Procedures

Children with gastroenterology (stomach) problems should be seen by a specialist who can diagnose and treat their problem. When a patient first comes to meet with the gastroenterologist, he or she will have a physical evaluation, and the doctor will talk to the parents and child about their medical history.

Much of the time tests are ordered to help diagnose what is wrong. Typical tests can include blood tests, analyzing urine and stool, and imaging studies such as X-rays and ultrasound. In addition, specialized tests are available, including:

  • Endoscopy

    You will receive an intravenous sedative and pain medication. Once comfortable, the physician will then examine the area using an endoscope—a lighted tube with a small camera at the end. The physician will be able to view any abnormalities and take a tissue samples (biopsies) if necessary.

  • Biopsy

    Any suspicious mass of tissue or tumor is subject to a biopsy, or removal of cells from the mass. This is the only technique that can confirm the presence of cancer cells. The doctor will use a general or local anesthetic depending on the location of the mass, and then remove a sample of tissue to send to the lab. The sample is sent to a pathologist, a physician who is an expert at identifying diseased cells in tissue samples. Very often, a few stiches are used to help the area heal, and tenderness is felt for a short period of time.

  • Esophageal Manometry

    This test measures the pressure inside the lower esophageal sphincter (LES). A thin tube is inserted through your mouth or nose and into your stomach. Once it is in place, the physician will gently pull the tube back into the esophagus and ask you to swallow. As you do so, the pressure and coordination of your muscle contractions will be measured. If the pressure is low or the LES is not relaxing properly, achalasia may be present. If the pressure is low or the LES is not contracting properly, it may indicate GERD (reflux disease).

  • Esophageal pH/Impedance Probe Study

    The esophageal pH/Impedance test is an outpatient procedure performed to measure the pH or amount of reflux that flows into the esophagus from the stomach during a 24-hour period.

  • Lactose Breath Hydrogen Test

    The hydrogen breath test is used to identify one of two conditions: lactose intolerance or an abnormal growth of bacteria in the intestine. The patient will blow up a balloon-type bag. Then, the patient will drink a solution and breath samples will be collected every 15-20 minutes for up to 3 hours.

  • Liver Biopsy

    During a liver biopsy, a physician numbs the area around the liver using a local anesthetic and then using a long, narrow needle obtains a tiny piece of liver tissue. A liver biopsy is used to determine the presence of inflammation, fibrosis, and to help diagnose various liver diseases.

  • Nuclear medicine: gastric emptying scan, gallbladder emptying scan, esophageal motility, salivogram 

    Nuclear medicine tests use small amounts of radioactive material to diagnose specific disease and help determine how severe they are.

  • Computed Tomography (CT) Scan

    CT scans use x-ray equipment and computer processing to produce 2-dimensional images of the body. The patient lies on a table and passes through a machine that looks like a large, squared-off donut. Doctors order CT scans when they want to see a two-dimensional image of the body to look for tumors and examine lymph nodes and bone abnormalities. If contrast dye is used to improve the computer image, the patient may need to avoid eating or drinking for 4 to 6 hours before the test. Patients should tell their provider before the test if they have any allergies or kidney problems.

  • Magnetic Resonance Imaging (MRI)

    This test uses a magnetic field, radiofrequency pulses, and a computer to produce detailed images of body structures in multiple places. You may be asked to drink a contrast solution for better imaging, and you will most likely lie on a moving table as pictures are taken. MRI is a more detailed tool than x-ray and ultrasound and for certain organs or areas of the body, it provides better images than CT. MRI may not be recommended if you have a pacemaker or other metal implant.

  • Fluoroscopy

    A fluoroscopy is a moving X-ray. As the X-ray beam passes through the chest area, a moving image is displayed on a monitor so the physician can assess function.

  • Rectal Biopsy

    A rectal biopsy is a procedure to remove a small piece of rectal tissue for examination.

  • Rectal Manometry Test

    Anorectal manometry is an outpatient test that evaluates bowel function in patients with constipation or stool leakage.