We provide expert, compassionate inpatient and outpatient care for children with a variety of gastrointestinal, liver, and metabolic disorders including inflammatory bowel disease, esophageal disorders, diarrheal disease, acute and chronic liver disease, and metabolic liver diseases, including lysosomal diseases. Our care team harnesses the expertise of gastrointestinal nursing, nutrition, radiology, surgery and genetics experts, as well as Yale’s programs in inflammatory bowel disease and liver transplantation. Our multidisciplinary approach for our patients with nonalcoholic fatty liver disease also includes a clinical psychologist, a dietician, and an endocrinologist.The program also offers selective shunts for patients with noncirrhotic portal hypertension. Gastrointestinal conditions we often manage include: Abdominal Pain Celiac disease Constipation/Encopresis Eosinophilic esophagitis/allergic bowel disease Failure to thrive Feeding problems/swallowing problems Helicobacter pylori infection Hirschsprung’s disease Lactose intolerance Malabsorption Pancreatitis Peptic ulcer disease Vomiting Our pediatric hepatologists treat a range of liver diseases. Some can be managed with medication, while others require surgery. For example,acute liver failure(ALF) occurs when many of the cells in the liver die or become very damaged in a short period of time. ALF has many causes, such as metabolic conditions or toxicity from incorrect dosages of acetaminophen.ALF can sometimes be treated with medication, if it is identified early, but about half of all children who develop ALF require a liver transplant. Biliary atresiais a disease of the liver and bile ducts that occurs in infants. In children with biliary atresia, bile—a liquid that helps the body digest fat—cannot properly drain from the liver. This damages liver cells and can lead to liver failure. Surgical procedures can correct bile flow problems, but the liver disease progresses and requires specialized care to improve growth, development, nutrition, and long-term outcome.A multidisciplinary team consisting of pediatric liver specialists, surgeons, and a dietician provides comprehensive care for patients with biliary atresia. Other hepatology conditions we treat include: Alagille syndrome Alpha-1-antitrypsin deficiency Autoimmune hepatitis Neonatal cholestasis Progressive Familial Intrahepatic Cholestasis (PFIC) Urea cycle defects Wilson's disease Primary Sclerosing Cholangitis Glycogen Storage Disease Viral hepatitis Hepatoblastoma Nonalcoholic fatty liver disease

Our program consists of dedicated experts and support staff committed to providing cutting-edge care to patients with disorders including autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC). Other conditions that we treat include sarcoidosis, autoimmune mediated liver injury, cholestasis of unknown etiology, lupus, cholangitis, secondary cholangitis, and overlap syndromes. The program offers effective and personalized treatment for patients with these rare liver diseases. Our doctors are specialists in these conditions, with expertise in interpreting biopsy scans, medications, and more. Patients also have access to our clinical trials, any of which offers new treatment options otherwise unavailable to the general public. We are partnered with the Yale School of Medicine Liver Center, one of only four National Institutes of Health-sponsored liver research centers in the United States, and the only center in Connecticut that offers comprehensive patient care for individuals with autoimmune and cholestatic liver diseases. Our team includes three autoimmune and cholestatic liver disease program experts. Together, they provide care that integrates basic, translational, and clinical research. Our combined expertise allows us to discuss and treat difficult cases from many angles. The research conducted by the program is mainly patient driven and aimed at finding solutions that patients can benefit from. The key to effective therapy is collaboration—we work closely with specialists in adult and pediatric gastroenterology, advanced endoscopy, transplant hepatology, transplant surgery, pathology, diagnostic and interventional radiology, gastrointestinal surgery, rheumatology, endocrinology, and medical and surgical oncology within the Yale Medicine system to provide any additional support that patients may need.

Fatty liver disease is a serious condition caused by stress placed on the liver from excess body weight. People with obesity, diabetes, high blood pressure, and high lipids are at high risk of developing fatty liver disease. Currently, weight loss of 7 to 10% has been shown to be the most effective way of improving fatty liver disease. Patients in our program lose weight safely and effectively through a combination of medications, endoscopic weight loss, bariatric surgery, and therapies. The Yale Medicine Fatty Liver Disease program provides a comprehensive suite of services to help manage the condition. These include: Medications: At Yale, many clinical trials are underway to test the ability of new drugs to treat fatty liver disease. Drugs under development seek to reverse the increased fat in liver cells (and the resulting inflammation and scarring), as well as the increased risk of liver cancer. Medical Weight Loss: Most weight loss medications are tablets that work by reducing appetite. Other medications mimic hormones that the body makes, and improve the body’s ability to manage extra calories. We also offer the OPTIFAST® program, which is a medically monitored weight management program that allows the patient, under the supervision of a physician, to consume a low-calorie diet and receive comprehensive lifestyle education. The typical OPTIFAST patient loses between 30 to 60 pounds in 18 to 24 weeks, and experiences a healthy decrease in blood pressure and cholesterol levels. Additionally, in clinical studies of the OPTIFAST program, about half of the people assessed had maintained enough weight loss for five years to improve their long-term health. Bariatric Surgery: Bariatric surgery is the most effective way to treat fatty liver disease, with improvement in approximately 90% of patients. Bariatric surgery can improve hepatic fibrosis and may reduce the risk of liver cancer. If patients have a body mass index (BMI) above 35, and they have fatty liver disease, they may qualify for bariatric surgery. Patients who are referred to our program will first undergo blood tests and imaging to determine whether or not they have NAFLD (nonalcoholic fatty liver disease) or NASH (nonalcoholic steatohepatitis). Once the diagnosis has been made, we will determine how serious the condition is, which helps our team develop a personalized treatment plan. We take a comprehensive approach to managing fatty liver disease—from medications to bariatric surgery—and refer severe cases to the liver cancer tumor board, if necessary.