Foregut Clinic

If your child is facing a complex disorder of the foregut, you’ve come to the right place at Phoenix Children’s. Our experienced specialists are highly trained to provide the latest treatment options, including therapeutic endoscopy and foregut surgery. We want your child to get their nutrition by mouth, and we can help them work toward that goal to improve their health and development

Foregut disorders affect the first part of the gastrointestinal (GI) tract – the esophagus, stomach and upper part of the small intestines. The most common issues we help children with include:

• Esophageal strictures and stenosis: Narrowing of the esophagus
• Antral webs: Rare condition at birth that causes a thin obstruction in the gastric outlet
• Gastric outlet obstruction: Condition when the lower part of the stomach is blocked where it leads into the small intestine
• Duodenal webs and stenosis: Conditions at birth that narrow or block the first part of the small intestine (duodenum) making it difficult to pass food along the digestive tract
• Post-surgical site stenosis and obstruction: When part of the digestive tract becomes narrow or blocked after surgery on the abdomen, often caused by scar tissue 
• Other foregut malformations

It’s important to discuss your child’s symptoms with their pediatrician, who can make a referral to a gastroenterologist. Be sure to tell them if your child has difficulty swallowing, vomiting, nausea, poor weight gain, burning  in the upper abdomen or other ongoing symptoms that could indicate a GI disorder. If your child needs specialized treatment, the gastroenterologist may refer you to our Foregut Clinic.

Phoenix Children’s is one of only a few programs in the United States to offer specialized services for children with foregut disorders. This type of specialization is important, because children aren’t just small adults – they have unique medical and anatomical needs.

Some families spend years trying to find the right treatment for their child. At Phoenix Children’s Foregut Clinic, you and your child can visit a therapeutic endoscopist and pediatric surgeon in one visit so we can create a treatment plan that is best for your child. In many cases, we can resolve the foregut issues in just a few treatment sessions.

We’ll support you and provide education every step of the way as we work toward our shared goal: appropriate development and good health for your child well into the future.

The foregut team at Phoenix Children’s provides a high level of care for children with complex conditions. Our team includes pediatric surgeons as well as pediatric gastroenterologists who are also trained in advanced or therapeutic endoscopy. Our advanced, combined approach includes:

• Imaging: X-ray, ultrasound, CT scans and/or MRI, endoscopic visualization and laparoscopic visualization. In combination, these provide detailed pictures of internal organs to direct care decisions made at the Foregut Clinic.
• Endoscopy: A thin, flexible tube with a light and camera, called an endoscope, allows us to access your child’s GI tract through a natural opening, like the mouth. By using very small tools through the endoscope, we can clarify the diagnosis and fine-tune the treatment to address and fix the GI problem. Where possible, endoscopic procedures are less invasive and can be done instead of more invasive surgery.
• Surgery: Combining surgical and endoscopic methods, some treatment options require access to the GI tract through the skin (called invasive) rather than through the mouth.

When possible, members of the Foregut Clinic strive to provide the most effective, but least invasive, options for your child. This approach has been shown to result in fewer complications, quicker recovery and shorter hospital stays. In fact, many of the treatment options in our Foregut Clinic are done as an outpatient.

When you schedule an appointment at the Foregut Clinic, you’ll spend time with a pediatric gastroenterologist trained in therapeutic endoscopy – as well as a pediatric surgeon – for a comprehensive visit. This multidisciplinary approach prevents you from making several trips to different specialist appointments. And it allows our full team to discuss all possible treatment options with you to determine the best next step for your child.

Based on the discussion during your first visit, and review of any other labs or imaging needed, our schedulers will help you arrange for treatment. We’ll follow up and help you take the steps needed throughout your child’s treatment plan.

Our ultimate goal is to allow your child to get their full nutrition orally (by mouth). We’ll work to advance them toward an age-appropriate diet with oral intake. Along the path to that goal, the team will update you on any adjustments and changes needed.

Rest assured, your child’s primary gastroenterologist will continue to follow your child’s progress. We’ll keep them updated on the treatment plan as we coordinate your child’s care.