Your first gastroenterology appointment: What to expect

Taking your child to their first paediatric gastroenterology appointment? Here’s what parents can expect, what to bring and the questions worth asking.

If your child has been referred to a paediatric gastroenterologist, you may be wondering what will happen at the first appointment.

You might be worried about what the doctor will ask, whether your child will need more tests, or what the appointment means for your child’s possible IBD diagnosis.

It’s completely normal to feel unsure.

The first gastroenterology appointment is usually about getting to know your child’s symptoms, medical history and overall health, working out what investigations may be needed and deciding what happens next.

You don’t need to have all the answers.

🩺 What is a paediatric gastroenterologist?

A paediatric gastroenterologist is a doctor who specialises in conditions affecting the digestive system in babies, children and teenagers.

They may see children with symptoms such as:

• Ongoing diarrhoea

• Abdominal pain

• Blood or mucus in the stool

• Constipation

• Poor appetite

• Weight loss

• Difficulty gaining weight

• Poor growth

• Persistent vomiting

• Unexplained fatigue

• Possible inflammatory bowel disease (IBD)

If your child is being investigated for Crohn’s disease or ulcerative colitis, the paediatric gastroenterologist will help determine what may be causing their symptoms and whether further testing is needed.

📋 Before the appointment

A little preparation can make the appointment much easier.

You may want to write down your child’s symptoms.

Include:

• When the symptoms started

• How often they happen

• Whether they are getting better or worse

• Bowel movement frequency

• Diarrhoea or constipation

• Blood or mucus in the stool

• Abdominal pain

• Urgency to use the toilet

• Appetite

• Energy levels

• Weight changes

• Sleep

• Any symptoms outside the digestive system

Don’t worry about making your notes perfect.

Even a few brief notes can be helpful.

💊 Bring a medication and supplement list

Write down everything your child takes, including:

• Prescription medications

• Over-the-counter medications

• Vitamins

• Iron supplements

• Probiotics

• Other supplements

Include the dose and how often your child takes each one if you know it.

If you’re unsure about a medication or supplement, bring the packaging or take a photo of the label.

🧪 Bring any test results you have

Depending on why your child has been referred, they may already have had blood tests, stool tests or other investigations.

If you have copies of the results, take them with you.

Your child’s doctor may be particularly interested in things such as:

• Full blood count

• Iron studies

• Inflammatory markers such as CRP and ESR

• Faecal calprotectin

• Stool infection testing

• Coeliac testing

• Liver and kidney tests

You don’t need to understand the results yourself.

The gastroenterologist can explain what they mean.

👩‍⚕️ What happens during the appointment?

Every appointment is different, but your child’s first gastroenterology appointment will usually involve a detailed conversation and physical examination.

The doctor may ask about your child’s medical history.

They may ask about previous illnesses, infections, hospital admissions, medications and other medical conditions.

Family history

You may be asked whether anyone in your family has:

• IBD

• Crohn’s disease

• Ulcerative colitis

• Coeliac disease

• Other autoimmune conditions

• Other gastrointestinal conditions

Bowel symptoms

Expect questions about your child’s bowel movements.

This might feel awkward, but these details are important.

The doctor may ask:

• How often does your child poo?

• What does it look like?

• Is there blood?

• Is there mucus?

• Is there urgency?

• Does your child have accidents?

• Does your child wake during the night to use the toilet?

• Does your child have pain before or during bowel movements?

Try to be as honest and specific as possible.

There are no embarrassing questions when it comes to your child’s health.

📈 Your child’s growth will probably be checked

Because children are still growing, growth is an important part of paediatric gastroenterology.

The doctor may check your child’s:

• Height

• Weight

• Growth pattern

• Body mass index

• Pubertal development, depending on their age

They may compare these measurements with previous measurements to see whether your child is growing as expected.

This is particularly important when investigating possible IBD because ongoing inflammation can sometimes affect appetite, nutrition and growth.

🩺 Your child may have a physical examination

The doctor may examine your child’s abdomen and check for things such as tenderness or swelling.

Depending on your child’s symptoms, they may also examine other parts of the body.

This doesn’t necessarily mean that something serious has been found.

A physical examination is simply one part of understanding the bigger picture.

🧪 Will my child need more tests?

Possibly.

The gastroenterologist will decide what investigations are appropriate based on your child’s symptoms, examination and previous test results.

Tests may include:

Blood tests

These can provide information about inflammation, anaemia, iron levels, nutrition and your child’s general health.

Stool tests

A stool sample may be used to look for infection and to measure faecal calprotectin, which can provide information about inflammation in the intestines.

Ultrasound or MRI

Imaging may be recommended depending on your child’s symptoms and what the doctor needs to investigate. Sometimes the ultrasound may be done at your appointment with your gastroenterologist if they have a machine available.

Endoscopy or colonoscopy

Some children may need an endoscopy, colonoscopy or both.

These procedures allow doctors to look inside the digestive tract and take small tissue samples called biopsies.

Not every child will need every test.

Your gastroenterologist will explain which investigations they recommend and why.

🔎 What if my child hasn’t been diagnosed with IBD yet?

This is important to remember.

Being referred to a gastroenterologist doesn’t automatically mean your child has IBD.

There are many different conditions that can cause digestive symptoms in children.

Your gastroenterologist will consider your child’s symptoms, medical history, examination and test results before deciding what needs to happen next.

If IBD is suspected, they may recommend further testing to determine whether your child has Crohn’s disease, ulcerative colitis or another condition.

💬 What should I ask?

It can be difficult to remember questions during an appointment, so write them down beforehand.

You could ask:

• What do you think is causing my child’s symptoms?

• Are you concerned about IBD?

• What other conditions could cause these symptoms?

• What tests does my child need?

• What will each test tell us?

• Does my child need a colonoscopy or endoscopy?

• How long will it take to get the results?

• Is my child’s growth on track?

• Are there any foods we should avoid?

• Should my child see a dietitian?

• Can my child continue normal activities and sport?

• What symptoms should make us contact you?

• What should we do if their symptoms suddenly get worse?

• When should we come back?

You don’t need to ask all of these.

Choose the questions that are most relevant to your child.

📝 What should I write down during the appointment?

There can be a lot of information to take in.

Consider keeping a note on your phone or bringing a notebook.

Write down:

What the doctor thinks

What are the possible causes of your child’s symptoms?

What tests are being ordered

Write down what each test is for.

What happens next

Make sure you know what you are waiting for and when you should expect to hear back.

Who to contact

Ask who you should contact if your child’s symptoms get worse before the next appointment.

The next appointment

Write down the date and time before you leave.

👧 Should my child be involved?

Yes, when appropriate for their age.

Even young children can be included in conversations about their health.

Older children and teenagers may appreciate being given the opportunity to answer some questions themselves.

It can also help them begin learning how to talk about their symptoms and understand their own healthcare.

You can ask the gastroenterologist to explain things directly to your child in language they understand.

This can be an important first step towards independence with their IBD care if they are eventually diagnosed.

❤️ What if the appointment feels overwhelming?

It can be a lot.

You may hear unfamiliar words, be asked questions you haven’t thought about and leave with more questions than you arrived with.

That’s okay.

You can ask:

“Can you explain that in simpler terms?”

“Can you write that down for me?”

“What are the most important things I need to remember?”

“Who should I contact if I think my child’s symptoms are getting worse?”

You don’t need to understand everything before you leave.

🎒 What to bring to your child’s first gastro appointment

Here’s a simple checklist:

☐ List of medications and supplements

☐ Recent blood test results

☐ Stool test results

☐ List of symptoms

☐ Notes about bowel movements

☐ Questions you want to ask

☐ Your child’s Medicare or healthcare information, if required

☐ A notebook or phone for taking notes

☐ Something for your child to do while waiting

☐ Any relevant letters or referral information

⭐ One thing to remember

Your first gastroenterology appointment is not a test that you have to pass.

You don’t need to know all the medical terminology.

You don’t need to remember every detail of your child’s symptoms.

And you don’t need to have everything figured out.

Your job is simply to share what you’ve noticed, ask questions and work with the healthcare team to understand what happens next.

If your child is being investigated for IBD, the first appointment may be the beginning of a longer process of testing and monitoring.

And if your child is eventually diagnosed with Crohn’s disease or ulcerative colitis, their gastroenterology team will help you understand the diagnosis and develop a treatment plan.

Take your questions with you. Take notes. And don’t be afraid to ask for something to be explained again.

You are your child’s most important advocate.