Daniel Gelfond, MD

Humaira Hashmi, MD

Colleen Nugent, MD, MS
166 Washington Avenue
Batavia, NY 14020
85 Wehrle Drive
Buffalo, NY 14225
Call us to Schedule An Appointment


Upper Endoscopy (EGD)
A thin flexible tube with a camera is inserted in the mouth to see the esophagus, stomach, and first part of the small intestine while the child is under general anesthesia, usually as an outpatient. The test is used to diagnose eosinophilic esophagitis, gastroesophageal reflux, celiac disease, peptic ulcer disease, gastric infections and inflammatory bowel disease. It is also used to look for causes of poor growth, and regurgitation. Small pieces of tissue, about the size of a pinhead, are usually taken for testing under the microscope. Through this approach, the doctor is able to actually see inside the GI tract to determine possible problem areas.


A flexible tube with a camera is used to look into the last part of the intestines (colon and terminal ileum). The test helps to evaluate polyps, inflammatory bowel disease, and other causes of gastrointestinal bleeding. Small tissue samples, the size of a pinhead, are taken. Polyps, which are growths of tissue lining the intestines, may also be removed. The test is done with general anesthesia, usually as an outpatient.

Capsule Endoscopy
A pill with a built-in camera, taking pictures twice per second, is swallowed, and a video of the entirety of the small bowel is produced, allowing full visualization from duodenum to ileum. This allows inspection for polyps, bleeding sites and areas of inflammation, to be identified. This procedure is generally done in the office setting

Liver Biopsy

A liver tissue sample is taken for diagnosing various conditions. Your child will be kept comfortable, with sedation or anesthesia, by a pediatric anesthesiologist. Local numbing agents are also applied at the site. Tenderness after the procedure may be handled with pain medication.

Hydrogen Breath Testing
Non-invasive testing, to test for lactose malabsorption, Helicobacter Pylori infection, or small bowel bacterial overgrowth can be performed on an outpatient basis. The Hydrogen Breath Test (or HBT) is used as a clinical medical diagnosis for people with Irritable Bowel Syndrome (IBS) and common food intolerances. The test is simple, non-invasive, and is performed after a short period of fasting (typically 8-12 hours).

When testing for conditions like Lactose Intolerance, Fructose Intolerance and Small Intestinal Bacterial Overgrowth (SIBO). Studies have demonstrated the importance of Hydrogen (H2) and Methane (CH4) production, indicating more than 30% of healthy adult subjects produce Methane in addition to or instead of Hydrogen increasing the ability for medical professionals to review the most comprehensive results to best aid them in their decision of how to best relieve patients IBS or other gastrointestinal disorders/symptoms.

Small Intestinal Bacterial Overgrowth (SIBO): Like the name suggests, SIBO is where bacteria enter your normally sterile small intestine and begin to colonize. Studies have indicated that potentially up to 80% of patients with IBS may in fact have SIBO which a Hydrogen/Methane Breath Test can easily and non-invasively help determine by ordering here. Treatment of SIBO can be done with a short course of antibiotics provided by your medical professional.

Common symptoms and reasons to test for SIBO: nausea, flatulence, diarrhea, constipation, malnutrition, Irritable Bowel Syndrome (IBS), Irritable Bowel Disease (IBD), Leaky Gut Syndrome, Chronic Fatigue Syndrome, Acid Reflux, Rosacea, Restless Leg Syndrome (RLS), Fibromyalgia, Gastroeseophageal Reflux Disease (GERD), Celiac Disease & Diverticulitis.

Lactose Intolerance (Lactose Malabsorption): Lactose intolerant individuals have insufficient levels of an enzyme called lactase. Lactase breaks apart lactose into Glucose and Galactose which can then be absorbed in your digestive system. When you lack this enzyme, the body cannot break down the lactose allowing it to make it to the stomach where bacteria flora break it down causing symptoms like bloating, cramps, diarrhea and nausea.

Fructose Intolerance (Fructose Malabsorption): Fructose is a simple monosaccharide which your digestive system can absorb without the need of additional digestive enzymes (like lactase is produced to breakdown lactose). When your digestive system is unable to absorb fructose before it reaches the large intestine, symptoms like bloating, nausea, abdominal pain, diarrhea, constipation, gas (flatulence) may occur.

Sucrose Intolerance (Sucrose Malabsorption):
Sucrose is a disaccharide composed of glucose and fructose. It is called cane sugar (or in some areas, beet sugar), reflecting the world-wide commercial source of the sugar. It is hydrolyzed by the enzyme sucrase, an a-glucosidehydrolase which is naturally occurring in the small intestine.

Rectal Suction Biopsy
A rectal suction biopsy is a procedure used to extract a tissue sample from the rectum for laboratory analysis. The rectum is the lowest six inches of the large intestine, and is located just above the anal canal. Its purpose is to store the body’s solid waste until it is released.
A rectal biopsy is an important tool for determining the causes of abnormalities in the rectum. It helps to diagnose problems that are identified in screening tests such as anoscopy or sigmoidoscopy.
Each test uses a different type of scope to observe the inner lining of the colon and rectum. The tests can identify the presence of conditions such as tumors, polyps, bleeding, or inflammation. However, anoscopy and sigmoidoscopy alone are limited in determining the causes of these abnormalities.

Additional Testing
Imaging tests, performed at hospitals or imaging centers, include X-rays (upper GI series, swallowing evaluations), ultrasound, MRI (magnetic resonance imaging), CT (computerized tomography) and nuclear medicine tests.

Capsule Endoscopy With the Sensor Belt

Colonoscopy Instructions