The MSK Kids Pediatric Gastroenterology, Hepatology, and Nutrition Program team members are experts in pediatric onco-gastroenterology. We focus on the digestive care of children with cancer, as well as those at higher risk of getting the disease. Cancer and its treatment can affect your child’s digestive function. It can cause uncomfortable symptoms such as nausea, vomiting, trouble eating and digesting food, and abdominal pain. Our team specializes in:
 

• Diagnosing the cause of your child’s symptoms.
• Creating a care plan to provide relief from symptoms.
• Creating a testing and surveillance plan for children and families with a higher risk of gastrointestinal (digestive system) cancers. We specialize in hereditary gastrointestinal cancers caused by a gene mutation (change) that can be passed down within a family.

What is causing my child’s symptoms?

Medications and other cancer treatments can cause side effects. They irritate the lining of the digestive tract, such as the stomach and intestines. Common symptoms for children include:

• Nausea (feeling like throwing up).
• Vomiting (throwing up).
• Abdominal (stomach) pain.
• Diarrhea (watery poop).
• Blood in the stool (poop).

We find the cause of your child’s symptoms and create a care plan for treatment. Symptoms that are mild may be managed by your child’s primary cancer care team. If symptoms are more severe or don’t go away, the care team may refer you to us for a consultation. We also work with the MSK Kids Pain and Palliative Care Team (PACT) to decide on the best approach for your child.

A Comprehensive Assessment

We offer a complete evaluation of children who have digestive discomfort. When possible, we avoid invasive tests, which are tests where we need to put something inside the body. Your child’s assessment may include:

• Getting a detailed history of their symptoms.
• A physical exam.
• Imaging, such as an abdominal (stomach) ultrasound or X-ray.
• Endoscopy, to see inside your child’s digestive tract using a flexible tube with a light and camera at its tip.             
• Stool (poop) sample analysis.

How You Can Help

During your consultation, our pediatric digestive care team will ask you questions about your child’s health. It is helpful for you to prepare answers to these questions. Examples of questions include:

• What are your child’s symptoms?
• When do they usually have these symptoms? How often?
• What makes the symptoms worse or better?
• If there is pain, where is it?
• What is the pain like? Is it dull, achy, sharp, burning, or pain that travels from one location to another?
• What is the color and consistency (hard, loose, or watery, for example) of your child’s stool? How often do they poop?
• If your child is vomiting (throwing up), how often? What does the vomit look like?

Specialized Pediatric Digestive Services

The team at MSK Kids offers specialized procedures to give your child the very best digestive care.

Advanced Interventional Endoscopy

Endoscopy uses a flexible tube called an endoscope with a light and camera at its tip. It lets us see the inside of your child’s mouth and throat and down the esophagus (food pipe). Your child is asleep during this procedure and does not feel a thing.

Care for People With Hereditary Cancer Syndromes

Our team is part of the Pediatric Cancer Predisposition Screening Program. We have expertise in treating hereditary cancers caused by gene mutations that can be passed down within a family. Your child’s genetic background may increase their risk for digestive cancers. We offer genetic counseling and testing for your child, and for family members related to your child by blood.

We also monitor your child’s condition to catch cancer early, when it’s easier to treat. This process is called surveillance. We monitor hereditary polyposis syndromes using surveillance endoscopy. Polyposis is when there are many polyps (growths of tissue) in the digestive system. Polyps aren’t cancerous but can sometimes become cancer, such as colorectal cancer.

Treatment of Stem Cell Transplant Complications

Graft-versus-host disease (GVHD) is a possible side effect of an allogeneic stem cell transplant. Allogeneic means that the stem cells come from someone else (a donor). This stem cell transplant is a treatment for certain types of cancer and non-cancerous blood disorders.

GVHD happens when immune cells from the donor attack your child’s tissues, causing irritation, inflammation, and other discomfort. GVHD often affects the digestive tract. Our pediatric gastroenterologists work with MSK’s Multidisciplinary Graft-Versus-Host Disease Clinic to give expert care to children, adolescents, and young adults with GVHD.

Care for Children Needing Feeding Support

The pediatric digestive care specialists at MSK Kids are part of an expert team that treats children who have trouble feeding. During and after cancer therapy, children may face challenges with eating, including the need for a feeding tube.