Pediatric Gastroenterology Procedures & Tests

At University Hospitals Rainbow Babies & Children’s, gastrointestinal tests and procedures are performed by pediatric experts. Because we are a large dedicated pediatric hospital, we know how to care for wiggly, curious little bodies who might also be scared, confused and in distress.

In most of our clinics, we’re able to optimize the patient and their family’s time at appointments by performing multiple tests or procedures during one visit. This helps reduce the number of visits required and times a child might need to be sedated.

All tests and procedures are performed in a sensitive, kid-friendly environment filled with patience and compassion by highly experienced specialists who go to great lengths to make sure our young patients feel comfortable. In addition to the pediatric gastroenterologists and surgeons, our pediatric anesthesiologists and pediatric nurses play critical roles in creating this nurturing and comfortable environment.

During a visit, a child might experience one or more of the following tests and procedures:

Biofeedback Therapy for Constipation Treatment

This therapy involves electronically monitoring body functions to train patients how to voluntarily control functions that are typically automatic. Biofeedback therapy for constipation targets pelvic floor muscles that work together to pass stools. This helps patients gain more control over these muscles and improve bowel control. Therapy sessions typically occur every two to four weeks for a total of five to six sessions.

Range of Biopsies for Diagnostic Analysis

A tissue sample is removed from the body and analyzed. We perform a number of biopsies in our division, including:

• Percutaneous liver biopsy: Using a long needle, often in combination with ultrasound, this method obtains a liver tissue sample.
• Rectal suction biopsy: Using a small tube, placed a few centimeters into the rectum, suction removes a small tissue sample.

Breath Tests Evaluate Function

Fairly simple tests to perform, the patient blows into a balloon-like device and then the air is evaluated for certain conditions. Two breath tests we commonly use to diagnose digestive conditions include:

• Hydrogen breath analysis: This analysis is used to measure hydrogen in a patient’s breath. If large amounts of hydrogen are present, this could indicate problems in the upper or lower intestines because hydrogen in the digestive tract is produced only when bacteria found in the lower intestine makes contact with undigested food. This means either bacteria are overgrowing into the small intestine or that food is not getting completely digested before passing into the large intestine.
• H. Pylori breath test: This test evaluates a patient’s breath for signs of bacteria called Helicobacter pylori (or H. pylori), which can cause inflammation of the stomach lining and/or ulcers if left untreated.

Colon Polypectomy Removes Colon Polyps

This procedure removes abnormal growths or polyps from the colon, which are then analyzed for any cellular issues.

Colonoscopy Evaluation for a Range of Conditions

A test that looks at the full length of the large intestine, this can help check for abnormal growths, inflamed tissue, sores or ulcers and bleeding. It uses a long, flexible, lighted tube called a colonoscope. The tube is put into your child’s rectum up into the colon while your child is sedated. This tube lets the provider see the lining of the colon and take out a tissue sample or biopsy to test it.

• Sigmoidoscopy: This procedure is a colonoscopy that looks at only the lower part of the colon including the rectum and sigmoid colon. This is a less invasive screening than a full colonoscopy and requires less preparation.

Endoscopic Diagnostic Tests

This test uses a camera at the end of a long tube called an endoscope which is used to look at your child’s digestive tract. We’ll also collect tissue samples or biopsies during this process and look at them more closely in the lab. Endoscopies can be challenging to perform on children, especially newborns, infants and toddlers. Our skilled team of specialists is highly experienced in performing them on little ones.

• Capsule endoscopy: Rather than inserting a tube into the esophagus, a pill with a tiny camera is swallowed and takes pictures of the digestive tract and transmits them via wireless connection. This helps us see parts of the small intestine that cannot be seen through other diagnostic tests.

Endoscopic Botox injections Relax Muscles

This procedure is used to relax the muscle at the bottom of the esophagus to help with a condition called achalasia, which causes vomiting and difficulty swallowing. Although the effects of Botox generally wear off within three to five months, this is a much less invasive treatment than surgery, yet it is nearly as effective and has fewer risks.

Endoscopic Retrograde Cholangiopancreatography

Combining endoscopy with X-rays, we treat conditions affecting bile and pancreas ducts such as leaks, scarring, gallstones and cancer. The endoscopic retrograde cholangiopancreatography procedure is performed at UH Rainbow Babies & Children’s Hospital in collaboration with adult gastroenterologists from University Hospitals.

Esophageal Procedures Monitor and Improve Function

• Esophageal pH Probe Monitoring is performed by inserting a ring into the esophagus that measures how much and how often a child experiences reflux of acid for 24 hours.


• Esophageal dilation is a procedure that’s done to dilate or stretch an area of the esophagus that has narrowed and made swallowing more difficult. This narrowing can be caused by a number of factors, but in children, it’s most likely caused by scarring from acid reflux.

Fecal Microbial Transplantation Provides Innovative Treatment

Fecal microbial transplantation is an innovative procedure that takes stool from a healthy donor and transplants it into a person who has chronic clostridium difficile or C. diff., which can occur when antibiotics kill too many good gut bacteria. At UH Rainbow Babies & Children’s Hospital, we can perform the fecal transplant procedure through either a colonoscopy or enema to place the transplanted stool as high into the colon as possible in order to produce the best outcomes. Generally, it takes one to three weeks for the good gut bacteria to replenish.

Manometry Tests Measure Motility

Pediatric GI specialists at UH Rainbow Babies & Children’s provides a range of tests used to measure the motility or muscle movement in the digestive tract, including:

• Anorectal manometry test – measures motility in the anus and rectum by inserting a small, flexible probe into the rectum. It can be used to evaluate conditions in patients experiencing constipation or fecal incontinence.


• Esophageal manometry test – measures motility in the esophagus by inserting a small, flexible probe through the mouth to evaluate patients who are most often experiencing problems eating and swallowing

Percutaneous Endoscopic Gastrostomy (PEG) Placement

Performed by pediatric surgeons at UH Rainbow Babies & Children’s, our skilled team places a feeding tube directly into a child’s stomach for nutritional support.