My specialty is pediatric and adolescent gastroenterology, hepatology and nutrition. This means I am trained to diagnose and treat medical problems dealing with the entire digestive tract including problems in swallowing, vomiting and/or excess spitting, screaming babies, abdominal pain, constipation, stool soiling, chronic diarrhea, liver and pancreatic disorders. My specialties also include nutritional problems such as failure to gain weight, weight loss, failure to grow normally and obesity. I work with people from birth to age 21 years. I especially enjoy working with adolescents.

I work with your primary physician in determining the cause of your problem, when possible, and helping you treat it. The evaluation begins with your first visit when we discuss the problem and some of the possible factors contributing to it.

It is extremely helpful if you write out as much about the problem as you can and bring it to the first visit. Without a written reminder it is difficult, if not impossible, for you to remember all of the details and dates of the problem.

If you can arrange for someone else to care for other family members at home rather than bringing several children with you to the appointment, it is also very helpful. If you are trying to watch siblings it is difficult for you to concentrate on the patient and the problem for which help is being sought. If you are distracted and your attention divided, it is also more difficult for me to concentrate on the child or individual with problems.

Since most problems for which you will seek consultation with me are ongoing and of at least several months duration, it is helpful if your primary physician sends information prior to the first visit. This information should include all lab data, X-rays, ultrasounds and test results already undergone along with complete results - not just "normal" summarizations. If available, a growth chart, or several previous weight and height measurements for the patient also help provide insight into the problem.

After taking a detailed history and examining the patient, the appropriate lab investigations will be ordered. In the case of HMO patients the investigations will be recommended to your primary physician for him/her to order if they agree. A return visit will be required to go over information obtained by you in the interim, to review the results of the laboratory tests and to re-evaluate your child. When the results of the initial laboratory investigations are normal, additional studies are frequently indicated if the patient is continuing to experience difficulties.

You NEED TO RETURN to discuss the test results. Telephone medicine is rarely, if ever, adequate for difficult problems requiring consultation and leads to dissatisfaction on both your and our part and to unsatisfactory care for your child.

Several return visits may be necessary to determine the cause and proper treatment for your child's problem. When the initial investigation and treatments have been completed, your primary physician will be provided with the necessary information for ongoing care. When the complexity of the problem requires, I work with the primary physician in providing ongoing care and treatment.

I am looking forward to working with you in the diagnosis and treatment of you/your child's GI problem(s).

Sincerely,
Marilyn Gregory Porter M.D.

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