News:
Covid-19:
Before your visit, please note the currently valid corona pandemic-related regulations of the state government and the clinic(general corona information link).
As a general rule: In the event of suspected COVID-19 symptoms, during quarantine measures or after contact with people who have tested positive, your appointment in our special consultation hours must be postponed.
Until further notice, we cannot offer fructose or lactose breath tests. (Exceptions are possible if a max. 48-hour-old negative PCR test for COVID-19 is available)
Restricted consultation hours:
In the current situation, our care is focussed on complex cases.
This may lead to an extension of the regular appointment waiting times for requests for chronic abdominal pain, constipation, functional complaints and second opinions. We ask for your understanding.
Care of children with intestinal, liver and pancreatic diseases at the Department of Paediatrics and Adolescent Medicine
Dear patients and parents, dear colleagues,
The paediatric gastroenterology department treats more than 1000 children and adolescents with intestinal, liver and pancreatic diseases every year. In particular, we also care for patients with rare diseases and are affiliated to the Centre for Rare Diseases (ZSE) Ulm. Diagnostics are usually carried out on an outpatient basis and, if medically necessary, on an inpatient basis. Findings are discussed on an interdisciplinary basis with other specialist departments and institutes at the University Hospital.
If necessary, our paediatric nutritional advice service or the paediatric clinic's psychological service are consulted.
We invite you to find out more on our website. If you have any questions, please do not hesitate to contact us directly.
Breath test diagnostics, impedance pH-metry and endoscopy
Getrud Moll and Bärbel Streiftau
Appointments for functional examinations:
Tel.: 0731-50057370
Mon + Tue + Thu 9.00 am - 1.00 pm
| Registration | Consultation hours | |
kinder.ambulanz@uniklinik-ulm.de Phone: 0731-500 57330 | Mon/Thu/Fri
| 08.30 - 12.00
|
Appointments for new patients can generally be made by telephone (0731-500-57330) or by email(kinder.ambulanz@uniklinik-ulm.de), subject to a referral after a fax request using the initial registration form including the previous findings by the attending GP or paediatrician OR registration by colleagues within the clinic .
Follow-up appointments are arranged on site or by email/telephone (see above).
Due to the high number of appointment requests, the regular waiting time for an initial appointment in the consultation hour is several weeks, depending on the urgency. The initial registration form is used for quick and targeted diagnostics as well as for scheduling appointments appropriate to the request. The indication for functional diagnostic interventions is always provided by us. As the doctor in charge, please complete our questionnaire carefully and send/fax it to us with the relevant findings.
Initial registration form for referrers
bring to the appointment
Bring to the appointment:
If you come to us with your child, please bring with you
- the insurance card
- a valid referral slip
- all previous findings
- if necessary, a stool sample (max. 48 hours old)
- at the first visit also: the yellow U-booklet and the vaccination card
and in the case of chronic abdominal pain and/or failure to thrive
Please also remember to bring food and reading material/toys in case you have to wait.
Range of services
- Chronic inflammatory bowel disease (IBD)
- Paediatric gastroenterological endoscopy
- Chronic intestinal failure, short bowel syndrome, severe and complex nutritional disorders (home parenteral nutrition, permanent enteral tube feeding (PEG))
-Immunological or endocrinological diseases involving the gastrointestinal tract or liver
- Functional abdominal pain syndrome (diagnostics)
- Liver and biliary tract diseases
Congenital diseases and malformations of the gastrointestinal tract
Acquired diseases of the gastrointestinal tract
- Severe functional bowel disorders
- Infections of the gastrointestinal tract
- Food allergies (e.g. cow's milk protein allergy) - Malabsorption,maldigestion syndromes cow's milk protein allergy)
- Malabsorption, maldigestion syndromes
- Lactose intolerance, fructose malabsorption
- Chronic intestinal failure, short bowel syndromeChronic intestinal failure, short bowel syndrome
- Gastroesophageal reflux disease (GERD)
- Motility disorders (M. Hirschsprung's disease, chronic intestinal pseudo-obstruction, therapy-resistant chronic constipation)
- Inflammatory bowel diseases: Crohn's disease, ulcerative colitis, indeterminate colitis, eosinophilic gastroenteropathy and lymphocytic indeterminate colitis, eosinophilic gastroenteropathy and lymphocytic colitis
- Coeliac disease
Pancreatic diseases
- Hereditary pancreatitis
- Autoimmune pancreatitis
- Pancreatic insufficiency (cystic fibrosis, M. Schwachmann, M. Pearson)
Liver and biliary tract diseases
- Viral hepatitis
- Autoimmune hepatitis
- Primary sclerosing cholangitis
- Metabolic diseases with liver involvement (e.g. Wilson's disease)
- High-resolution ultrasound of the abdomen
- H2 breath tests (fructose, lactose, glucose), C13 urea breath test (H. pylori)
- Oesophageal impedance pH-metry
- Endoscopy (oesophagogastroduodenoscopy, colonoscopy, rectoscopy, PEG/PEJ insertion, polypectomy)
- Liver biopsy
- Capsule endoscopy in cooperation withCapsule endoscopy in cooperation with the Clinic for Internal Medicine I
- Serology for coeliac disease and small intestine biopsy
- Disaccharidase determination in small intestine biopsy
- Deep rectal incision biopsy
- Stool tests (e.g. Helicobacter pylori)(e.g. Helicobacter pylori antigen, faecal fat determination, calprotectin, etc.)
The paediatric gastroenterology department is currently involved in several national and international randomised studies, including the investigation of drug therapies for chronic inflammatory bowel disease (IBD) and bowel cleansing.
The paediatric gastroenterology department in Ulm is currently conducting study projects on live vaccination of children and adolescents undergoing immunosuppressive therapy for autoimmune hepatitis, chronic inflammatory bowel disease and after liver transplantation.
In collaboration with the Department of Psychology at the University of Potsdam, the influence of a cognitive and behavioural intervention in children with chronic functional abdominal pain is being investigated as part of a randomised study.
We are a member of the Registry for Chronic Inflammatory Bowel Diseases (CEDATA) of the Society for Paediatric Gastroenterology and Nutrition (GPGE) www.gpge.de/cedata-gpge/ and participate in projects of the IBD Porto Group of the ESPGHAN.
AG PD Dr Carsten Posovszky
Research profile
Our research focuses on the genetics and pathophysiology of rare inflammatory and non-inflammatory bowel diseases.
Our aim is to better understand the pathogenesis of inflammatory bowel diseases and to enable targeted personalised therapy.
To this end, the influence of genetic changes in children with inflammatory bowel disease on the development, manifestation and course of the disease is being investigated. As part of the European COLORS in IBD project, whole-exome investigations are being carried out in early childhood inflammatory bowel disease to identify monogenetic diseases. Monogenetic inflammatory bowel diseases are used to gain a better understanding of the causes and mediators of disease with the aim of personalised medicine.
Posovszky C, Pfalzer V, Lahr G, Niess JH, Klaus J, Mayer B, Debatin KM, von Boyen GBT
Age-of-onset-dependent Influence of NOD2/CARD15 gene variants on Disease behaviour and treatment in Crohn's disease BMC-Gastroenterology 2013, 13:77 doi:10.1186/1471-230X-13-77
Autoimmune polyendocrinopathy type I, or APECED syndrome, is a rare disease that can lead to muco-cutaneous candidiasis, autoimmune adrenal insufficiency and hypoparathyroidism in childhood. Other concomitant diseases, such as those affecting the intestines, are also frequently found. The disease is inherited in an autosomal recessive manner. It is caused by mutations in the AIRE gene, which codes for the transcription factor AIRE. We were able to show that the disease results in an autoimmune-mediated loss of gastrointestinal endocrine cells. The lack of enteroendocrine cells ultimately leads to gastrointestinal dysfunction with e.g. malabsorption, steatorrhoea.
Posovszky C, Lahr G, Schnurbein J, Buderus S, Findeisen A, Schröder C, Schütz C, Schulz A, Debatin KM, Wabitsch M, Barth TF
Loss of gastrointestinal endocrine cells in patients with autoimmune polyendocrine syndromes and gastrointestinal dysfunction.
J Clin Endocrinol Metab. 2012 Feb;97(2):E292-300. epub 2011 Dec 7.
Familial haemophagocytic lymphohistiocytosis (FHL) is a rare autosomal recessive inherited disease that leads to massive activation of macrophages. Most clinical symptoms are mediated by serum concentrations of inflammatory cytokines. The disease can be cured by bone marrow transplantation. FHL is genetically heterogeneous and several disease-causing genes have been identified. FHL type 5 is caused by genetic alterations in the STXBP2 or Munc18-2 gene. Interestingly, some of these patients also have impaired intestinal function. Based on histopathological and electron microscopic examinations of the intestinal mucosa in patients with STXBP2 gene mutations, we were able to demonstrate a disruption of the membrane organisation of the intestinal epithelial cells, which leads to chronic intestinal failure. The interaction of the STXBP2 protein with other membrane fusion proteins and their significance for exocytosis and membrane transport was further elucidated in co-operation with other research groups.
Stepensky P, Bartram J, Barth TF, Lehmberg K, Walther P, Amann K, Philips AD, Beringer O, Zur Stadt U, Schulz A, Amrolia P, Weintraub M, Debatin KM, Hoenig M,Posovszky C
Persistent defective membrane trafficking in epithelial cells of patients with familial hemophagocytic lymphohistiocytosis type 5 due to Munc18-2/STXPB2 mutations
Pediatr Blood Cancer. 2013 Feb 4. doi: 10.1002/pbc.24475.
Vogel GF, van Rijn JM, Krainer IM, Janecke AR, Posovszky C, Cohen M, Searle C, Jantchou P, Escher JC, Patey N, Cutz E, Müller T, Middendorp S, Hess MW, Huber LA.
Disrupted apical exocytosis of cargo vesicles causes enteropathy in FHL5 patients with Munc18-2 mutations
JCI Insight. 2017 Jul 20; 2(14) doi: 10.1172/jci.insight.94564
Patients with chronic inflammatory diseases under immunosuppression are particularly at risk of serious infectious diseases. Investigations of immunological functions under immunosuppressive therapy in vitro serve to assess the individual risk of infection and should also enable effective and safe vaccinations with live viruses.
Schleker T, Jacobsen EM, Mayer B, Strauss G, Debatin KM, Posovszky C
Preserved in-vitro immunoreactivity in children receiving long-term immunosuppressive therapy due to inflammatory bowel disease or autoimmune hepatitis
Molecular and Cellular Pediatrics (2018) 5:1-8 DOI 10.1186/s40348-018-0079-0
We are a training centre for paediatric gastroenterology recognised by the Baden-Württemberg Medical Association and the GPGE (Society for Paediatric Gastroenterology).
We organise training courses and run a paediatric gastroenterology quality circle for quality assurance and further training.
25.07.2018 Paediatric gastroenterology quality circle
We care for our patients in close cooperation with colleagues from Paediatric Surgery, the Department of Internal Medicine I and the Department of Paediatric Psychology and Psychosomatics, Dietary Counselling and the Department of Child and Adolescent Psychiatry.
We are a training centre for paediatric gastroenterology recognised by the Baden-Württemberg Medical Association and the GPGE (Society for Paediatric Gastroenterology) . We regularly take part in quality assurance measures and lead a paediatric gastroenterology quality circle.