Commonly Treated Conditions

Common GI Conditions Treated by Dr. Ulmer:

Abdominal Pain

Childhood abdominal pain is an uncomfortable and sometimes debilitating condition that may indicate the presence of an underlying medical problem. The pain may be acute, that may begin suddenly and last for a short period of time such as a week or less; or it may begin slowly and become chronic, that is, lasting for a longer period of time. A wide variety of problems may cause abdominal pain in children and the treatment options are often dependent on the cause of the pain.
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Nausea and/or Vomiting

Almost all children will, at some point, experience acute nausea and vomiting, most commonly after exposure to certain viral or bacterial infections. However, some children suffer with chronic or frequent vomiting and nausea not caused by an acute illness. Episodes of nausea and vomiting can be severe at times and often occur without explanation. These children require the attention of a Pediatric Gastroenterologist, such as Dr. Ulmer, to determine the cause of the vomiting and find an effective mode of treatment.
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Liver Disease and Hepatitis

Hepatitis is a term used to describe inflammation of the liver. Such inflammation may be caused by viral infections (eg. Hepatitis A, B or C), but there are many other possible causes including exposure to toxins, certain medications and genetic disorders. Though hepatitis often causes symptoms, a child can be asymptomatic and have liver disease for a very long time before parents or physicians become aware of it. It is important to identify liver disease and inflammation as soon as possible to monitor the condition and determine the best course of management.
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Lactose Intolerance

For children, dairy products are a primary component of a healthy and balanced diet. Not only do these foods taste good, but they also deliver high doses of calcium necessary for growing bodies. Unfortunately for some children, drinking a glass of milk or eating a bowl of ice cream is not so simple. It could lead to hours of uncomfortable symptoms such as bloating, diarrhea, abdominal pain, nausea and/or vomiting, and may range from mild to severe.
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Inflammatory Bowel Disease

When a child is diagnosed with Inflammatory Bowel Disease (IBD), the first step is understanding that these diseases are chronic but also treatable. Inflammatory bowel diseases, include Crohn’s disease, Ulcerative Colitis, and sometimes Indeterminate Colitis. IBD may present in a variety of ways and will vary from child to child but may include abdominal pain, diarrhea, weight loss or rectal bleeding. Fortunately, long-term treatment and tailored medical therapies can help most children diagnosed with Inflammatory Bowel Diseases go on to live healthy and normal lives.
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Gastrointestinal Reflux (GERD)

Gastrointestinal reflux disease, or GERD, is a GI health condition occurring in people of all ages, including infants and children. It can present with spitting up, pain, heartburn or fussiness in infants. It may be necessary to consult with Dr. Ulmer if a child experiences persistent reflux that causes excessive fussiness, interferes with growth, feeding or breathing. In otherwise healthy children, a trial of medical therapy is often initiated to evaluate for clinical response. In some cases, additional evaluation with imaging and/or endoscopy is required as symptoms of reflux might mimic other diseases such as gut allergies (eg. Eosinophilic Esophagitis). Once evaluation is complete, Dr. Ulmer can make a diagnosis and develop a plan for treating and managing the condition.
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Swallowing Problems (Dysphagia)

Pediatric dysphagia is a disorder identified by a child’s difficulty with eating or swallowing foods and liquids. It can be caused by difficulty mobilizing the mouth, lips and tongue (oral dysphagia) or by difficulty with swallowing in the throat (pharyngeal dysphagia). It is important for children with swallowing problems of any kind to see a pediatric gastroenterologist such as Dr. Ulmer, as severe cases of dysphagia can lead to nutritional deficiencies, impaired growth and a higher risk of developing chronic illness.
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Constipation

Constipation is a common problem in childhood present in kids of all ages as well as adults. In fact, nearly all children or young adults experience constipation at some point, though some experience it more frequently and have more symptoms and complications. At Kids and Tummies, we address the clinical symptoms and discomfort associated with constipation, along with thorough evaluation of medical and behavioral causes. We work closely with our patients and families to establish individualized treatment plans to address constipation as well as fecal soiling.
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Celiac Disease

Celiac disease is an autoimmune reaction to gluten, a protein found in many common foods and drinks. Most children eat gluten containing products on a daily basis with no adverse reaction or intolerance. For children with celiac disease, however, even small amounts of gluten can cause damage to the lining of the intestines, often leading to pain, bloating, constipation or diarrhea, nausea, vomiting or weight loss. Gluten-associated intestinal inflammation can prevent the proper absorption of nutrients in children and if the disease is left unmanaged, a child with celiac disease can eventually develop nutritional deficiencies, as well as growth and development problems. Untreated/inadequately treated celiac disease can also place children at increased risk for the development of other autoimmune diseases, such as thyroid disease, diabetes, skin disease and arthritis. Long term gluten exposure in celiac children can potentially lead to gastrointestinal cancers. Though screening for celiac disease can be performed through specific blood testing, definitive diagnosis requires endoscopy with tissue biopsy.

IF YOUR CHILD IS BEING REFERRED TO DR. ULMER FOR AN EVALUATION OF CELIAC DISEASE, DO NOT START A GLUTEN FREE DIET. MAKE SURE YOUR CHILD CONTINUES TO CONSUME GLUTEN CONTAINING FOOD PRIOR TO HAVING ANY BLOOD WORK OR ENDOSCOPY.

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Obesity and Fatty Liver (NASH)

Non-alcoholic steatohepatitis (NASH) is a disease in which fat accumulates in the liver, causing inflammation and irritation. Also known as non-alcoholic fatty liver disease, this condition can occur in childhood, especially in children who are overweight or obese. Children with metabolic disease and type II diabetes can also develop NASH. Fat builds in the liver slowly over time, allowing many children with fatty liver disease to go undiagnosed. In severe cases, however, the condition can progress to cause liver damage and the development of scar tissue (fibrosis). Fibrosis may eventually lead to cirrhosis of the liver and liver failure, requiring a liver transplant. At Kids and Tummies, Dr. Ulmer may utilize laboratory evaluation and imaging to both diagnose and manage NASH.
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Other Common Conditions

  • Infant formula intolerance
  • Gastrointestinal bleeding/blood in the stool
  • Gastritis
  • Helicobacter pylori gastritis
  • Food sensitivity and allergies
  • Failure to thrive and malnutrition
  • Irritable Bowel Syndrome (IBS)
  • Eosinophilic Esophagitis
  • Jaundice
  • Pancreatic Disease
  • Gastrointestinal infections
  • Gastrointestinal motility problems
  • Gastrointestinal manifestations of Cystic Fibrosis
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