Consultations

Infant and toddler stomachaches, vomiting, and diarrhea can often put parents and pediatricians in difficult situations. These symptoms can be indicative of numerous diseases, and with timely treatment, we can prevent the development of more serious problems.

Here are the most common reasons why parents turn to a pediatric gastroenterologist in this age group:

• Poor development: inadequate weight gain, lack of appetite, infant regurgitation.
• Reflux (GERD): backflow of stomach content can irritate and/or damage the esophageal mucosa, thereby causing inflammation and erosion. In children, the symptoms are often not typically digestive but appear in different forms. The disease can be managed well with medicinal or non-medicinal treatment.
• Food allergy: the first symptoms can occur in infancy but can also develop later. Symptoms can include: diarrhea, vomiting, bloating, bloody stool, hives, dry skin, eczema, and occasionally runny nose, sneezing.
• Absorption disorder: a disease in any part of the intestinal system can cause this and it prevents the absorption of nutrients and water. This can trigger various food intolerances and allergies.
• Lactose intolerance: due to the deficiency or malfunctioning of the lactase enzyme, the body cannot digest lactose. The most characteristic symptoms of lactose sensitivity are bloating, increased gas production, excretion, diarrhea, abdominal cramps.
• Coeliac disease (gluten sensitivity): it is an inflammatory condition triggered by the body's sensitivity to gluten. It causes varying degrees of damage to the villi of the small intestine and subsequent absorption disorders.

Gastroenterological diseases in older children:

• IBS (Irritable Bowel Syndrome): characterized by recurring abdominal pain, diarrhea, constipation, and increased intestinal gas. The cause is unknown, but stress can play a role in its development.
• Chronic intestinal diseases: in addition to IBS, this includes conditions like ulcerative colitis and Crohn's disease, which are associated with inflammation.
• Liver diseases: one of the most common that can develop in childhood. The symptoms can be similar to those of the flu: chills, headaches, loss of appetite, sometimes diarrhea, abdominal complaints, jaundice.

In many cases, we encounter a variety of abdominal symptoms along with skin, respiratory, and other organ or system-wide, diverse symptom clusters. Often these symptoms are caused by improper diet and lifestyle, but it can also be due to stress.

With proper attention and necessary examinations, these diseases and conditions can be well-diagnosed and treated. Our pediatric gastroenterologists, Dr. Anna Gimesi and Prof. Dr. András Arató, warmly welcome their patients to their clinics!

For the first appointment, Dr. Anna Gimesi conducts a medical examination supplemented with nutritional advice for the child aged 0-2 years and their parent, which lasts 40 minutes.

Dermatology involves the identification, examination, and treatment of diseases of the skin, hair, nails, and subcutaneous connective tissue. Symptoms on the skin often correlate with other diseases in the body, so it's important to pay attention to its signals. Dermatology also includes the important area of skin cancer screening and differentiating it from benign skin changes.

Process of Dermatological Examination

The examination starts with the collection of the patient's medical history: the doctor asks the patient in detail about his symptoms and previous diseases. Previous results and treatment sheets can provide useful information for the treating doctor, so it's important to bring them to the consultation. This is followed by a physical examination of the altered skin area. A dermatoscope, a special microscope equipped with a magnifier and internal lighting, can be used as an aid to the examination. After a thorough examination, the dermatologist makes a suggestion for treating the problem, or may recommend further examinations if needed. It can also happen that the skin symptoms point to a problem originating from an internal organ, in such cases the dermatologist helps decide which specialist to turn to.

Most common skin changes in children:

• Warts: A common type of warts is the common wart. This skin change can develop on the fingers, soles, limbs. Another type is the running wart, which usually appears on the face or limbs and is able to spread extremely quickly. The swimming pool wart is a virus-related change, which can cause itching.
• Moles: Their appearance, size, and color can vary. A part of the moles can turn into melanoma (malignant tumor), so it's important to regularly check them. If you notice any change in a mole, it's advisable to see a doctor as soon as possible.
• Rashes: There can be various causes of rashes appearing on the skin surface: it could be caused by a virus or food allergy, so a dermatological examination is essential for accurate determination and effective treatment.
• Eczema (dermatitis): Eczema is an inflammatory disease of the skin, accompanied by a dry, red, strongly itching sensation, then the formation of small blisters, and as a result of scratching, small wounds, scabs, and peeling may appear. Treating childhood eczema is crucial as it can prevent possible respiratory problems (asthma, hay fever, bronchitis) that may develop later on.
• Acne: Acne is a skin disease that develops in adolescence, during which the hair follicles - the pores of the skin - are clogged by dead skin cells and sebum - usually on the face. As a result, closed blackheads appear first, which over time evolve into purulent blisters. Without appropriate treatment, they can leave scars, but with dermatological care, permanent skin defects can be successfully prevented.
• Hair loss: The generally or patchy occurring hair loss can have various causes, it can be caused by metabolic disorder, fungal infection, bacterial focus in the body (such as tonsillitis), or iron-deficient anemia, but in every case, it's worth consulting a dermatologist.

Dermatological treatment options:

The treatment of dermatological changes can vary depending on their type and size.

• Diathermy: a tissue separation procedure and hemostasis based on the concentrated heat effect of electric current.
• Removal of skin lesions with a Volkmann's spoon: certain skin changes can be removed with a special sharp tool, the Volkmann's spoon.
• Cryo treatment: Cryotherapy is a freezing procedure in which the skin tissue to be removed is cooled to freezing with liquid nitrogen, causing it to die, allowing new, healthy skin to form in its place.

In the case of certain skin changes, moles, it may be justified to regularly check them and document them with photos. With the help of the photos, the changes of the mole can be tracked, so it can be recognized in time if there is a pathological change.

Pediatric cardiology deals with congenital heart defects and acquired cardiovascular diseases in newborns, infants and children. Acquired diseases include, for example, inflammatory diseases, cardiac arrhythmias and heart muscle diseases. The most common congenital heart diseases are septal defects. Almost all cardiac diseases can be treated with surgery or medication, but as with any other disease, it is important to recognize the problem early.

What symptoms should you pay attention to?

• Gray discoloration of lips, nail beds, and skin
• Lack of weight gain, loss of appetite
• Fatigue
• Cardiac complaints occurring during exercise
• Fast breathing, difficulty breathing
  
  

Who are at risk?

• Those with a family history of heart disease
• Low birth weight premature babies
• Overweight children
  
  

Pediatric cardiology consultation

During a pediatric cardiology consultation, the specialist learns about the child's complaints and previous illnesses and also asks whether heart disease has ever occurred in the family. This is followed by a physical examination, after which the doctor may recommend additional tests in order to establish an accurate diagnosis.

Child cardiology complex examination + heart ultrasound

During a complex examination, the physical examination is supplemented with additional instrumental procedures and a cardiac ultrasound examination. The examinations are not painful, they can only represent an unusual situation for the child. Before visiting the cardiologist, the parent should discuss what to expect during the examination at a level appropriate for the child's age.

Nephrology is a branch of internal medicine that deals with the function of the kidneys and their disorders. The pediatric nephrologist examines and treats abnormalities in kidney function, including anatomical abnormalities of the urinary tract, urinary tract infections, and urinary retention disorders (such as problems in developing toilet training, nighttime bedwetting occurring beyond a certain age).

Clarifying the causes behind respiratory symptoms in children is also very important, because we can help eliminate symptoms with specialized treatment accordingly.

Respiratory diseases caused by viral and bacterial infections are common among community-going children, but if a general practitioner prescribes the 5th or 6th antibiotic course within a year, other diseases should also be considered. In such cases, it is worth visiting a pediatric pulmonologist, allergist, immunologist. Impeded nasal breathing, constant coughing, and suffocation can take a toll on a child, as it prevents them from sleeping, makes them tired, and reduces their ability to concentrate. With appropriate drug treatment and knowledge of the triggering causes, and eliminating them, we can provide substantial help.

The successive appearances of allergic diseases from early childhood are referred to as atopic march. The first phase of this is eczema occurring in infancy, followed by asthma in preschool, and allergic rhinitis in school age. If symptoms of allergic rhinitis occur in summer, in good weather, pollen-induced allergy should be considered. If the rhinitis persists throughout the year, the causes may include house dust mites, mold, or animal fur, saliva, and excrement.

At our pediatric pulmonology clinic, skin testing can be performed to identify respiratory and food allergies. With lung function and imaging examinations, changes in the lungs can be identified. Laboratory tests can confirm an immunodeficient condition, which can also be a cause of recurring respiratory symptoms.

At Duna Medical Center, we welcome our youngest patients at our pulmonology clinic, where we particularly deal with the following problems:

• asthma, hay fever
• allergic skin changes
• insect bite allergy
• pneumonia
• sinusitis
• croup
• laryngitis
• bronchitis
• urticaria