CWPW's pediatric gastroenterologists are dedicated to providing comprehensive diagnostic and therapeutic services for children from infancy to adolescence with a wide variety of problems of the gastrointestinal tract, liver or biliary system, as well as children with nutritional disorders. We also strive to educate our patients and their families about their problems as well as training medical students, residents, and fellows in pediatric gastroenterology and nutrition.

We are fully equipped to perform a number of diagnostic procedures to help make a definitive diagnosis. The diagnostic center includes state-of-the-art endoscopic equipment, allowing for complete evaluation of the upper and lower intestine. These procedures can be performed in an outpatient setting, utilizing conscious sedation when necessary. Other tests that can be performed include testing to look for excessive amounts of acid reflux into the esophagus, tests that can look for abnormalities in the motility of the upper and lower GI tract, biopsy of the liver, and tests that can determine the amount of calories required for proper growth.

The staff is diversified in its interests with special expertise in the diagnosis and management of a variety of conditions:

Along with bumps and bruises, sniffles and sneezes, allergies and accidents, parents also have to be aware that certain foods might adversely affect their child's health. In the case of lactose intolerance, it can mean a radical change in dietary habits to keep children healthy and well-nourished.

Lactose intolerance is exactly as its name implies — an intolerance or inability to digest lactose, a sugar found in milk and other dairy products. Howard Bostwick, MD, explains that parents can easily mistake lactose intolerance for a milk protein allergy. “Lactose intolerance is very specific and related to the inability to digest lactose, the sugar in milk products,” Dr. Bostwick says. “If you're lactose intolerant, you're missing an enzyme that enables you to digest lactose.” Milk protein allergy, on the other hand, mostly occurs in younger children, but can produce symptoms similar to lactose intolerance.

Howard Bostwick, MD

Dr. Bostwick points out that primary lactose intolerance “is virtually unheard of” in infants. In fact, intolerance is the norm in most of the world as we age, and certain cultures are more susceptible than others. “It's extremely common in Asia to be lactose intolerant, yet Northern Europeans usually are not lactose intolerant,” he says. In addition, the condition is genetically linked; if one or both parents have it, there's a good chance their child will too. Symptoms of lactose intolerance can range from abdominal pain, diarrhea and nausea, to flatulence and bloating after eating a milk-based food. “The symptoms are pretty obvious,” Dr. Bostwick states. Abdominal pain should be checked out by a pediatrician, but “it's probable that some abdominal pain in children is caused by lactose intolerance.”

Suspicion of lactose intolerance can be confirmed by a hydrogen breath test, Dr. Bostwick says. A patient fasts and is then given a solution of pure lactose and water. The child's breath is tested every one-half hour for two hours. Since there is no natural production of hydrogen in the breath, if it is detected, it's a sure bet the child is lactose intolerant.

The most common measures to take, Dr. Bostwick says, are to eliminate milk products from the child's diet. A replacement enzyme can also be added to aid in digestion if any milk product is consumed.

Dr. Bostwick cautions that eliminating milk products also deprives children of much-needed calcium, an essential mineral for bone development. A child diagnosed with lactose intolerance “should definitely have supplemental calcium,” Dr. Bostwick says.

There are a number of lactose-free products on the market that parents can investigate, Dr. Bostwick says, and substances like soy milk “are a viable alternative” to regular cow's milk. However, he stresses that parents of lactose-intolerant children should consult with their pediatrician and even a nutritionist to devise a plan for avoiding milk products, and ensuring proper nutrition and calcium intake.