Gastrointestinal and Colorectal Conditions

Sometimes children have a hard time moving their bowels due to a gastrointestinal or colorectal condition. These conditions can be present from birth (congenital) or can develop over time. At Mount Sinai, our expert pediatric surgeons have extensive experience diagnosing and treating these conditions. We individualize treatment plans based on the condition and your child’s overall health. Whenever possible, we apply innovative minimally invasive techniques, which reduce post-operative pain and scarring, and promote faster recovery.

Gastrointestinal and Colorectal Conditions

The gastrointestinal and colorectal conditions we treat most often include:

• Anorectal malformations are abnormal development of the rectum and/or anus that we may be able to spot even before birth. Some babies may even have absolutely no anal opening at all. Instead, they may have an abnormal internal connection (fistula) of the gastrointestinal system to the genitourinary tract or skin.  
• Appendicitis, an infection and inflammation of the appendix, is one of the most common conditions seen in children. Appendicitis can range from an early minimally inflamed state to perforation.  
• Gastrocutaneous fistulas may arise after we remove a gastrostomy tube or G-tube, which we use to deliver nutrition directly to the stomach. Usually, the opening that connects the stomach to the skin will close spontaneously, but sometimes, if it has been there for an extended period, it may not.
• Gastroesophageal reflux disease (GERD) is a common condition that causes heartburn or acid indigestion.
• Gastrostomy tubes allow us to deliver food directly into the child’s stomach and gastrointestinal system, bypassing the mouth and esophagus. We use them for children who cannot consume enough calories orally to meet their nutritional and caloric needs.
• Hirschsprung’s disease causes children to be born unable to pass regular stools because of abnormal development of the nerves of their intestines (typically the rectum and colon, though occasionally the small bowel or the entire gastrointestinal tract).
• Inflammatory bowel disease (IBD) is chronic inflammation of the digestive tract. There are several types of IBD, including ulcerative colitis, which occurs in the colon, and Crohn’s disease, which can happen anywhere between the mouth and the anus. IBD is common among children and adolescents. While we cannot cure IBD, we can control the symptoms.
• Intestinal atresia and stenosis happens when part or all of the intestine becomes so narrow that nothing can pass through it. Children can be born this way (congenital) or the condition can develop over time.
• Intestinal malrotation, or abnormal rotation or alignment of the intestines, can compromise blood supply to the intestines, which can be life threatening.    
• Intussusception is a telescoping of one part of the intestine into another part (intussusception), which causes vomiting, abdominal pain, or bloody bowel movements.
• Meckel’s diverticulum happens when the intestine fails to develop properly in utero, leading to an abnormal outpouching of part of the intestine. This can later cause significant bleeding or a blockage of the intestine.
• Necrotizing enterocolitis (NEC) can develop in premature babies who have an intestinal infection. NEC can range from a mild case to a severe disease.  
• Pyloric stenosis is an abnormal thickening of the pyloric muscle, which separates the stomach from the first part of the small intestine. This condition can cause vomiting and dehydration and usually occurs in the first few weeks of life.    

Diagnosis and Treatment

We generally diagnose gastrointestinal and colorectal conditions based on symptoms and physical examination. In addition, tests of blood, urine, and stool can provide important information. We might also use imaging tests, such as X-rays to help us understand what is happening in your child’s body.

Treatment varies based on the condition and your child’s overall health. Typically, certain conditions are treated with medicine or other non-surgical approaches, such as enemas. Other conditions require surgery to correct the problem. We use minimally invasive approaches whenever possible.