Swedish News Blog

Advocating for Children with Severe Food Allergies

Uma Pisharody, MD, FAAP

Uma Pisharody, MD, FAAP
Pediatric Gastroenterologist

Eosinophilic Gastrointestinal Disorders (“EGIDs”) are a severe form of gastrointestinal inflammation that results from food allergy.  Children and adults in the U.S. are increasingly being diagnosed with this condition that unfortunately requires strict elimination diets, and many times, a life-long inability to eat foods that most of us take for granted each day, including dairy, wheat, soy, and eggs. 

For children requiring such restrictive diets, pediatric gastroenterologists like me work hard to find adequate alternate sources of nutrition.  For my patients with EGIDs, I often prescribe special “elemental formulas” as a treatment to both heal the intestinal inflammation and prevent further harm.  These formulas are completely allergen-free while meeting 100% of a child’s nutritional needs. 

However, in the state of Washington, most ....

Worrying about your child's growth

Shirley Vacanti, RN, BSN

Shirley Vacanti, RN, BSN
Clinical RN, Pediatric Endocrinology; Swedish Pediatric Specialty Care

The above letters reflect many of our children’s feelings when they are first seen by Dr. Kletter. They and their families arrive to the Pediatric Endocrinology clinic with hope that something can be done.

Children are usually followed by their pediatrician or primary care provider. The following questions are guidelines for parents who are worried about their child’s growth. While any “yes” to the questions may not indicate a problem, it warrants a discussion with your child’s healthcare provider.

  • Is my child the shortest or tallest in the class?
  • Is my child unable to keep up with children of the same age in play?
  • Is my child growing less than 2 inches or more than 3 inches a year?
  • Is my child showing signs of early sexual development (before age 7 in girls and before age 9 in boys)?
  • Has my 13 year old girl or 15 year old boy failed to show signs of sexual development?

An experienced pediatric endocrinologist will evaluate the following possible causes of short stature and growth failure:

Ketogenic diet as a treatment for seizures

Jenny Schoenfeld, ARNP

The ketogenic diet is a high-fat, low-carbohydrate diet that has proven to be effective in the treatment of seizures. In fact, the ketogenic diet is one of the oldest and most effective treatments available for patients with seizures regardless of age, from infancy through adulthood. The ketogenic diet must only be started under direct medical supervision.

Here are some frequently asked questions about the ketogenic diet:

What is the ketogenic diet?
The ketogenic diet is a special high-fat diet that often includes heavy cream, butter and vegetable oils to provide the necessary fat. The diet eliminates carbohydrate rich foods such as bread, rice, cereals, pasta, cookies, and cakes.

How effective is the diet at controlling or eliminating seizures?
Studies that have followed children on the diet for long periods reveal that at least 2/3 of all children on the diet have a significant reduction in seizures by over half. 1/3 of children on the diet will have a greater than 90% reduction in seizures, with half of these children ....

Child’s Belly Discomfort Caused By Allergies

Jonah Essers, MD

Jonah Essers, MD
Pediatric Gastroenterologist

This is one of the most common questions that I get asked in the office. Allergic diseases are certainly becoming more and more prevalent in the developed world. General pediatricians and specialists are on ‘high-alert’ for this when evaluating a child that may be sick. Within the realm of intestinal diseases, however, a true allergy is actually not very common. To understand this, we must first understand what ‘allergy’ means.

An allergy is a biologic response from our body’s immune system. When our body senses a foreign invader, our army of immune cells attacks it. It does this by releasing chemicals into the blood stream and/or in to the organs where the threat may lie. Those chemicals are meant to destroy the invader, but often hurt our healthy organs as well. For example, airborn pollen may land in your eye, the immune system senses that pollen, releases those chemicals, and as a consequence we get itchy, puffy, watery eyes. The same thing can happen in the bowel if we ingest food that we are allergic to.

Intestinal manifestations of food allergies

One of the more common sites of an allergic response to food is in the esophagus—the food pipe. When the esophagus gets inflamed, it can manifest in a few different ways: heartburn symptoms, chest pain, chronic dry cough, upper abdominal pain, frequent regurgitation, or food that is stuck the chest. The name of this is Eosinophilic Esophagitis. Food allergies lower in the bowels can cause diarrhea, blood in the stool, abdominal pain, weight loss, anemia, and fatigue.

There are usually other red flags

One of the most important things to remember is ....

Swedish Pediatrics to Host Annual Holidays at The Hospital Community Event Dec. 2

Swedish News

SEATTLE, Nov. 20, 2012 - Swedish Pediatrics is hosting its third-annual Holidays at The Hospital event for their patients, families, friends and the community at large. This free and festive holiday celebration will be held Sunday, Dec. 2 from 1-4 p.m. in the 1101 Madison Medical Tower lobby on the Swedish/First Hill campus in Seattle.

Neck lumps in children: focus on the thyroid

Robert L. Weinsheimer, MD

Robert L. Weinsheimer, MD
Pediatric General Surgeon

There are a wide variety of nodules or lumps of the neck. We often group these growths by their location. While many lumps are simply lymph nodes, which come and go, growths near the “Adam’s apple” merit special attention. Lumps in the front/center of the neck are most likely related to the thyroid gland.

The thyroid gland produces thyroid hormone ,which is a chemical that influences a wide range of the body’s functions such as digestion, heart rate, mood, appetite, temperature, and growth. Younger children tend to have a congenital remnant called a thyroglossal duct cyst. During fetal development, the thyroid gland originates from the base of the tongue and then descends down the front of the neck to its eventual home just below the “Adam’s apple.” These cysts often get infected because they maintain a connection to the throat allowing bacteria to enter. If infected, we treat these initially with antibiotics and then perform a surgery to remove the cyst and its connection. The procedure is typically performed as a day surgery.

Actual thyroid nodules are increasing in number with an estimate around 1% of children developing an abnormal thyroid growth. These can vary from not at all threatening to cancerous (malignant). Firm, solid nodules that grow over time tend to be more concerning; but regardless of how they feel, these lumps should be evaluated by your physician. Sometimes the nodules cause an overactive thyroid gland which can lead to symptoms such as: feeling warmer than others, rapid or irregular pulse, anxiety/nervousness, insomnia, tremor, weight loss. Other times the nodule due to its size may cause symptoms such as pain, hoarse voice, difficulty swallowing.

Evaluation of these nodules includes ...

Fixing Chest Wall Deformities: A Minimally Invasive Option

Robert L. Weinsheimer, MD

Robert L. Weinsheimer, MD
Pediatric General Surgeon

Pectus excavatum often referred to as either "sunken" or "funnel" chest is the most common congenital chest wall deformity affecting up to one in a thousand children. It results from excessive growth of the cartilage between the ribs and the breast bone (sternum) leading to a sunken (concave) appearance of the chest.

(Image source)

Although present at birth, this usually becomes much more obvious after a child undergoes a growth spurt in their early teens. Pectus excavatum can range from mild to quite severe with the moderate to severe cases involving compression of the heart and lungs. It may not cause any symptoms, however, children with pectus excavatum often report exercise intolerance (shortness of breath or tiring before peers in sports), chest pain, heart problems, and body image difficulties. The last issue deserves some attention as children often are reluctant to discuss how the appearance of their chest affects their self-esteem globally. There is a bias even within the medical community to dismiss the appearance component of pectus excavatum as merely "cosmetic", but I view the surgery to fix this congenital defect as corrective and support the idea that the impact of its appearance should be considered. I have seen patients emotionally transformed in ways that they and their families never expected.

Thanks in great part to the pioneering work of Dr. Donald Nuss (a now retired pediatric surgeon in Virginia), we have a well-proven minimally invasive option to correct pectus excavatum: the Nuss bar procedure. This involves ...

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