Once it’s determined my child should be treated for GI (gastrointestinal) symptoms, how do I make an appointment for a consultation?
You can either telephone Thoughtful House Center for Children at 512-732-8400 or email info@thoughtfulhouse.org to request a "new patient intake packet". After we get this back from you, we send you the GI packet, which contains directions on how to complete the necessary patient narrative (history) as well as prescriptions for the blood tests, stool tests, and abdominal X-ray that we need to have before your child’s consultation with Dr. Krigsman.
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Why do I need to have all these tests done before the doctor will see my child?
It may seem like a long slow process, but gathering scientific information before your first appointment actually addresses your child’s GI issues more quickly. The doctor needs to have the lab tests, the narrative, and the X-ray pictures in order to investigate the nature and severity of the GI symptoms. Having these tests completed prior to the first office visit with Dr. Krigsman allows him to focus a comprehensive medical “picture” of your child when he meets you both.
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What if some of my child’s tests are sent to Thoughtful House and then, for whatever reason, we can’t do the rest until several months later?
That's okay. However, some test results will have to be repeated if they are more than six months old.
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How long does it take to get an appointment for the initial consultation?
That depends on when we get the required narrative (from you) and blood/stool/X-ray tests (from the lab) back. When your child’s chart is complete, it’s reviewed by Dr. Krigsman, and an office staff-member will call you to schedule the appointment for initial consultation. Families who live more than one hundred miles away from our offices are offered the option of an initial consultation by telephone if it’s too difficult to come in person.
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Does Dr. Krigsman only treat children with an autistic spectrum disorder?
No. While the majority of children that we treat for gastrointestinal problems have an ASD, we also treat their unaffected siblings, many of whom suffer from similar GI problems.
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What is the cost of a consultation for a child’s GI problems?
The initial costs cover a phone consultation, chart review, and office visit. For those children who require endoscopic or other diagnostic evaluation, the following fees may be applicable: operating room facility fee, anesthesiologist, and pathologist. These three items are covered under most insurance plans, but it is your responsibility to confirm with your insurer whether the services required are covered.
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With which insurance plans does Dr. Krigsman participate?
Dr. Krigsman is not an in-network provider with insurance companies. Families with out-of-network benefits usually recover the majority of the physician fee. Other related expenditures may be covered, and you should check with your insurer for details on insurance-related issues.
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Who will pre-certify a diagnostic endoscopy?
While Thoughtful House arranges for pre-certification with your insurance company, it’s important to understand that "pre-certification" only means that your insurer has received clinical information about your child from the GI Clinic at Thoughtful House, and has determined that a diagnostic endoscopy is medically necessary. It is NOT their guarantee of payment, nor is it an acknowledgement that the insured child is covered for the particular service by your insurance plan.
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How can I pay for the procedure(s)?
Personal checks, money orders, and major credit cards are accepted.
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What if it’s difficult for me to pay for treatment?
Payment plans are available; Thoughtful House understands that most families with ASD children are financially strained.
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What is the cancellation policy for Dr. Krigsman’s clinic?
Forty-eight hour notice is required for cancellation; we must charge for less notification. (It is unfair to be casual about appointments, because there are many children waiting for treatment.)
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What’s the point of diagnostic endoscopy/colonoscopy in a child with an autistic spectrum disorder?
ASD children with chronic GI symptoms often have a disorder known as Autistic Enterocolitis. It is extremely painful, and responds well to treatment, but most ASD children can’t tell us about it, in part because it’s “normal” to them. The only way to diagnose it with certainty is to perform a diagnostic endoscopy and biopsy, in order to inspect the tissue samples under a microscope.
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What can be done for a child who has autistic enterocolitis?
Medication and dietary intervention can be prescribed to alleviate any or all of the symptoms, which might include diarrhea, pain, constipation, abdominal distension, malabsorption, and growth retardation. Treating autistic enterocolitis does not treat autism as such, but relieving these children of chronic physical pain can make them more available for the therapies that are specific to autism.
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Why not simply treat all ASD children who have GI symptoms as if they have autistic enterocolitis, and bypass the need for an invasive endoscopy?
It’s poor medical practice to empirically treat conditions that have not been properly diagnosed. This is especially true for treatments involving medications with potentially unpleasant or dangerous side effects, and for conditions in which empiric treatment would obscure the validity of subsequent proper diagnostic tests.
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How can I find out about where to stay when we come to the GI Clinic?
We maintain a list of local lodging facilities. A few of these have mini kitchens.

If my child is already experiencing diarrhea or loose bowel movements, why do I have to give a laxative and enema as part of the bowel prep?
It’s common to have significant amounts of stool in the colon even in the presence of diarrhea. It must be removed beforehand so that the colonoscopy can be done as safely and accurately as possible.
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Why can’t my child drink any red fluids the day of the prep?
The red dye used as food coloring could stain the intestinal lining, and it could be confused with blood in the intestine.
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How long does an endoscopy take?
It takes about half an hour for an upper endoscopy, and about one hour for a lower endoscopy.
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Will my child be unconscious during the procedure?
Endoscopy in children can only be performed with general anesthesia.

How long is the recovery period immediately after a diagnostic endoscopy?
One to two hours, after which time you can leave the hospital.
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If we are from out of town, how soon can we leave Austin to return home?
We ask that patients remain in the Austin vicinity until the following morning.
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