Paediatric gastroenterologist in Latviawhere to get treatment, how to verify certification, what this doctor does

A paediatric gastroenterologist diagnoses and treats disease of the digestive tract, liver, biliary tract and pancreas, along with feeding and eating problems in children. Symptoms of these conditions often differ from adults, which is why recognising them early matters.

• Gastro-oesophageal reflux disease
• Inflammatory bowel disease
• Coeliac disease and food allergies
• Constipation and diarrhoea, including chronic
• Malabsorption, chronic anaemia, poor weight gain
• Chronic non-infectious liver disease

A family doctor or paediatrician is enough for short-lived digestive upsets. A paediatric gastroenterologist is needed when symptoms become chronic, when a child gains weight poorly, or when endoscopy is required.

Paediatric gastroenterology in Latvia has no separate sub-specialties. The Children's Clinical University Hospital treats the field as a gastroenterology and hepatology profile, meaning digestive tract and liver health handled by one team.

• Six years of medical study and a doctor's degree, at RSU or the University of Latvia.
• Entry to the paediatric gastroenterology programme requires a copy of a valid paediatrician certificate, or university confirmation of third-year residency in the base specialty "Pediatrs". For doctors without the paediatrics specialty the programme runs six years.
• Residency in paediatric gastroenterology. The RSU programme runs 3 years, 132 credit points or 198 ECTS, tuition 5,120 EUR per year. Programme page: RSU residency programme.
• Compulsory modules: paediatric gastroenterology inpatient and outpatient work for 124 weeks, pathology for 2 weeks, hepatology and infectious disease for 2 weeks, and adult gastroenterology for 4 weeks. Optional modules include endoscopy, nutrition science and paediatric dietetics.
• In the second and third years, research and teaching run alongside clinical training, with theory seminars three times a month and 48 hours of duty shifts per month.
• The state examination covers theory plus defence of a research project.
• The certificate is valid for 5 years. Recertification requires 250 continuing education points, at least 60 per cent tied to the base specialty, plus a 48.38 EUR fee.
• Entry in the practitioners register must be renewed every 5 years.

• Languages. Consultations run in Latvian and Russian, with some doctors also working in English.
• The child's age. Some specialists see babies from 1 month, so for infants it is worth checking in advance.
• Endoscopy. If fibrogastroscopy or colonoscopy is likely, ask where it is done for children and whether anaesthesia is used.
• Chronic disease follow-up. For coeliac disease, inflammatory bowel disease and liver disease, continuity with one doctor matters.
• Second opinion. A child's legal representative may freely choose the doctor and institution.

• Bring the child's medical records, growth data, results of earlier tests and investigations, and a list of medicines taken.
• A food diary helps if symptoms track specific foods, as does a note of stool frequency and consistency.
• At the visit the doctor takes a detailed history, examines the child, and orders blood tests, stool tests, ultrasound, X-ray or endoscopy as needed.
• Based on the results the doctor makes a diagnosis and sets a treatment plan, which may involve medicines and dietary changes.
• For chronic conditions the doctor arranges follow-up monitoring with planned repeat visits.

Children under 18 are among the groups exempt from patient co-payments, so a state-funded paediatric gastroenterology consultation on referral costs the family nothing. That also covers state-funded endoscopy and ultrasound, for which adults would pay 7.00 EUR and 4.00 EUR respectively. A private visit is paid by the parents or an insurer.

• Patient co-payment for a child under 18Price EUR: 0.00Provider: NVD
• Gastroenterology consultation, adults and childrenPrice EUR: 32.00Provider: Veselības centru apvienība
• Private paediatric gastroenterology consultationPrice EUR: per clinic price listProvider: Premium Medical, Vesels bērns

The specialty body is the association "Latvijas Pediatru gastroenterologu asociācija" (Latvian Association of Paediatric Gastroenterologists), registration number 40008062672, registered address Dzirnavu iela 159B-36, Rīga, LV-1050.

Adult gastroenterology is represented by the Latvian Association of Gastroenterologists, a division of the Latvian Medical Association.

Certificates are issued by the Certification Council of the Latvian Medical Association, founded in 1988. The sector regulator is the Health Inspectorate.

If you have doubts about the care a child received, raise them first with the institution's management, which must operate a complaints and suggestions system. If that does not resolve it, the child's legal representative may submit a written complaint to the Health Inspectorate no later than two years after the alleged infringement. It is reviewed within 30 days, extendable to four months in complex cases. The procedure is set out on the Health Inspectorate site.