Overview

Symptoms of Gastrointestinal Disease

Procedures

Treatment of Gastrointestinal Disease

Gastroenterology FAQs

  1. Does my child need specialized gastrointestinal evaluation?
  2. How do I arrange a gastrointestinal consultation?
  3. What is included in the GI Intake Packet?
  4. Why do I need to have all these tests done before the doctor will see my child?
  5. What if I have already done some or the preliminary lab tests?
  6. Does my child have to fast or discontinue medications for the preliminary lab tests?
  7. How do I collect stool specimens?
  8. How long does it take to get an appointment for the initial consultation?
  9. Does Dr. Krigsman only treat children with an autistic spectrum disorder?
  10. What is the cost of a consultation for a child's GI problems?
  11. With which insurance plans does Dr. Krigsman participate?
  12. Who will pre-certify a diagnostic endoscopy?
  13. How can I pay for the procedure(s)?
  14. What if it is difficult for me to pay for treatment?
  15. What is the cancellation policy for Dr. Krigsman's clinic?
  16. What is the point of diagnostic endoscopy/colonoscopy in a child with an autistic spectrum disorder?
  17. What can be done for a child who has autistic enterocolitis?
  18. Why not simply treat all ASD children who have GI symptoms as if they have autistic enterocolitis, and bypass the need for an invasive endoscopy?
  19. How can I find out about where to stay when we come to the GI Clinic?
  20. If my child is already experiencing diarrhea or loose bowel movements, why do I have to give a laxative and enema as part of the bowel prep?
  21. Why can my child not drink any red fluids the day of the prep?
  22. How long does an endoscopy take?
  23. Will my child be unconscious during the procedure?
  24. How long is the recovery period immediately after a diagnostic endoscopy?
  25. If we are from out of town, how soon can we leave to return home?



Gastroenterology FAQs
 

1.Does my child need specialized gastrointestinal evaluation?

Any child with an ASD and a history of troublesome gastrointestinal symptoms should undergo an evaluation by a pediatric gastroenterologist experienced in diagnosing and treating GI disease in children with ASDS.

Back to Top

 

2. How do I arrange a gastrointestinal consultation?

Interested patients should contact Alex Upham at 718-327-2200 ext 202 or e-mail her at alex@autismgi.com in order to receive our GI Intake Packet via e-mail.

Back to Top

 

3.What is included in the GI Intake Packet?

You will receive a set of four different attachments: GI Packet (all of the information about the lab testing and medical history you need to provide prior to your first appointment), Template Lab Orders (template lab orders for preliminary testing. You will need to work with your PCP/pediatrician to complete the tests.), Medical History Documents (information about your child’s condition that you will provide by answering questions) and Legal Forms (you will need to sign them before your first appointment is scheduled).

Back to Top

 

4. Why do I need to have all these tests done before the doctor will see my child?

We completely understand that gathering all the information and completing the laboratory tests for our intake may seem a little overwhelming at times. Our intake is done in this manner to maximize your resources and decrease your waiting time. We have intentionally compressed a comprehensive GI evaluation into one process. You would typically visit the doctor (and pay for it), have the labs and tests prescribed (usually one or two at a time) with weeks or months in between. Patients who have gone to other gastrointestinal specialists have spent 12-18 months putting together the data that we gather over the course of weeks. Reviewing scientific information before your first appointment allows Dr. Krigsman to make fully informed decisions, lessens the chance of misinformation, and allows you to maximize the time you spend with him.

Back to Top

 

5. What if I have already done some of the preliminary lab tests?

Great! All tests that were done within the last 6 months will apply to our GI Intake Packet and do not have to be repeated. Please collect copies of those test results and send them to us. If you are uncertain if previous labs tests results are applicable to our intake, you can ask our intake coordinator to evaluate them for you.

Back to Top

 

6. Does my child have to fast or discontinue medications for the preliminary lab tests?

None of the preliminary lab tests require fasting. Some of the stool test results may be altered if your child is taking antifungal or antibacterial medications that require a prescription (e.b. diflucan, nystatin, nizoral, ampicillin, penicillin, zithromax, amoxicillin, among others). Therefore you should stop all prescription antifungals and antibacterials for two weeks prior to collecting the stool specimens.

Back to Top

 

7. How do I collect stool specimens?

Infant
Immediately after your child has a bowel movement, collect stool from the diaper.
Toddler
If your child is toilet trained, collect the bowel movement in a potty chair. Do not allow urine to contact the stool specimen. If (s)he is not toilet trained, collect stool from his diaper or training pants.
Older child

When your child is ready to have a bowel movement, put a "toilet hat" in place to collect the stool. Lift the toilet seat, put the toilet hat in place and lower the seat. Do not allow urine to contact the specimen. Do not collect the specimen from the toilet bowl.

Write your child's name, date of birth and the date and time of collection on the collection containers. Your lab should provide you with stool collection containers. The container type, specimen requirements and stability vary for each test. Collect the specimens even if your child has diarrhea; collect any blood or mucus if present.

Back to Top

 

8. How long does it take to get an appointment for the initial consultation?

Completion of our intake process should take no more than two weeks and we can usually schedule your first appointment within the following few weeks. Families who live more than one hundred miles away from our offices are offered the option of an initial consultation by telephone if it is too difficult to come in person.

Back to Top

 

9. Does Dr. Krigsman only treat children with an autistic spectrum disorder?

No. While the majority of children we treat for gastrointestinal problems have an ASD, we also treat their unaffected siblings, many of whom suffer from similar GI problems.

Back to Top

 

10. What is the cost of a consultation for a child's GI problems?

The initial costs of a GI evaluation consist of the preliminary laboratory testing and the fee for the intake consult. The majority of the preliminary laboratory tests should be covered by your insurance carrier, but Dr. Krigsman's consultation fees are not covered by insurance. For those children who require an endoscopic or other diagnostic evaluation, the following fees may be applicable: operating room facility fee, anesthesiologist, and pathologist. These costs are often covered by insurance, but it is your responsibility to confirm with your insurer whether the services required are covered. Contact our in-office reimbursement assistance coordinator, Misty Winkler, for further details.

Back to Top

 

11. With which insurance plans does Dr. Krigsman participate?

Dr. Krigsman is not an in-network provider with any insurance carrier. Families with out-of-network benefits usually recover the majority of the physician fee. Related expenditures are typically covered in full when the provider is in-network, and you should check with your insurer for details on insurance-related issues. Contact our in-office reimbursement assistance coordinator, Misty Winkler, for further details.

Back to Top

 

12. Who will pre-certify a diagnostic endoscopy?

Our in-office reimbursement assistance coordinator, Misty Winkler arranges for pre-certification with your insurance company. However, it is important to understand that "pre-certification" only means that your insurer has received clinical information about your child and has determined that a diagnostic endoscopy is medically necessary. It is NOT a guarantee by them of payment, nor is it an acknowledgement that the insured child is covered for the particular service by your insurance plan.

Back to Top

 

13. How can I pay for the consultation and any necessary procedure(s)?

Personal checks, money orders, and major credit cards are accepted.

Back to Top

 

14. What if it is difficult for me to pay for treatment?

Payment options are handled on a case by case basis. Patients can discuss payment options with reimbursement assistance coordinator.

Back to Top

 

15. What is the cancellation policy for Dr. Krigsman's clinic?

Forty-eight hour notice is required for cancellation; we must charge cancellations received less than 48 prior to the appointment date. (It is unfair to be casual about appointments, because there are many children waiting for treatment.)

Back to Top

 

16. What is the point of a diagnostic endoscopy/colonoscopy in a child with an autistic spectrum disorder?

ASD children with chronic GI symptoms often have treatable gastrointestinal diagnoses. Some of hese diagnoses appear related to the co-occurring diagnosis of ASD, while others occur with similar frequencies in both autistic and non-autistic children. As with most other medical conditions, accurate diagnosis is the cornerstone to appropriate therapy. In the case of ASD-associated bowel disease, accurate diagnosis is usually made only upon microscopic endoscopic examination and subsequent microscopic examination of tiny pieces of tissue obtained at biopsy.

Back to Top

 

17. What can be done for a child who has autistic enterocolitis?

Medication and dietary intervention can be prescribed to alleviate any or all of the symptoms, which might include diarrhea, pain, constipation, abdominal distention, malabsorption, and growth retardation. Treating autistic enterocolitis does not treat autism as such, but relieving these children of chronic physical pain can make them more available for the therapies that are specific to autism.

Back to Top

 

18. Why not simply treat all ASD children who have GI symptoms as if they have autistic enterocolitis, and bypass the need for an invasive endoscopy?

It is poor medical practice to treat conditions that have not been properly diagnosed. This is especially true for treatments involving medications with potentially unpleasant or dangerous side effects, and for conditions in which empiric treatment would obscure the validity of subsequent proper diagnostic tests.

Back to Top

 

19. How can I find out about where to stay when we come to the GI Clinic?

Please see our hotel and restaurant recommendations.

Back to Top

 

20. If my child is already experiencing diarrhea or loose bowel movements, why do I have to give a laxative and enema as part of the bowel prep?

It is common to have significant amounts of stool in the colon even in the presence of diarrhea. It must be removed beforehand so that the colonoscopy can be done as safely and accurately as possible.

Back to Top

 

21. Why can my child not drink any red fluids on the day of the bowel prep?

The red dye used as food coloring could stain the intestinal lining, and it could be confused with blood in the intestine.

Back to Top

 

22. How long does an endoscopy take?

An upper endoscopy takes about half an hour, and a lower endoscopy takes about 90 minutes.

Back to Top

 

23. Will my child be unconscious during the procedure?

Endoscopy in children is routinely performed under general anesthesia.

Back to Top

 

24. How long is the recovery period immediately after a diagnostic endoscopy?

One to two hours, after which time you can leave the surgery center.

Back to Top

 

25. If we are from out of town, how soon can we leave to return home?

We ask that patients remain in the vicinity until the morning following the procedures.

Back to Top




Pediatric Gastroenterology of New York & Texas   |   148 Beach 9th Street Unit 2B Far Rockaway, NY 11691   |   7901 Cameron Road, Bldg 3, Suite 110, Austin TX 78754