Category Archives: Pediatrics

New Solutions for Inflammatory Bowel Disease (IBD)

Posted on: January 12, 2016

Something to Cheer About

By Dr. Elie Abemayor

I remember the day when an 18-year-old cheerleader came to see me, she knew something was dramatically wrong—but she didn’t want to talk about it. The normally bouncy high school student was becoming less social, and she was losing weight. She was having bowel issues, and she really didn’t want to talk about it.

Northern Westchester Eli AbemayorAfter discussing her symptoms, I checked for blood in her stool, and then confirmed her diagnosis with a colonoscopy and a biopsy. She had ulcerative colitis, a form of inflammatory bowel disease (IBD). Luckily, her condition was still in the mild to moderate stage; after she started medications she had a complete reversal within a few weeks. She was able to get back to a healthy weight and her symptoms subsided.

IBD, which includes Crohn’s disease and ulcerative colitis (the cheerleader’s condition), plagues as many as 1.4 million Americans, according to the Centers for Disease Control and Prevention (CDC). Given the nature of the symptoms, many people wait too long to seek treatment. Treating IBD early can make such a big difference in being able to manage the disease successfully.

Both Crohn’s and colitis can be characterized by persistent diarrhea, abdominal pain, cramping, fatigue, and blood in the stool. The reason for these symptoms is chronic inflammation in the digestive tract, which interferes with normal digestion. Crohn’s disease can target any part of the gastrointestinal (GI) tract, from the mouth to the anus, and it can penetrate the intestine walls to affect nearby organs. Ulcerative colitis, on the other hand, only involves the colon or rectum and irritates only the inner wall of the intestine.

If you’re seeing a GI specialist about IBD, expect to be questioned in depth about your symptoms. If your doctor believes you may be suffering from Crohn’s disease or colitis, he or she may order a colonoscopy, endoscopy, or other imaging such as a CT scan to check for inflammation. A biopsy of the inflamed area may also be necessary to confirm the diagnosis. Although it’s not possible to cure these conditions with medications, there are many effective drugs that can control symptoms, as was the case with the cheerleader. Anti-inflammatory drugs can calm a severe attack; immune system modulators can also quell symptoms. Often we find that a combination of medications works best.

For more severe cases, surgery may be required. Not too many years ago, surgeons would remove the entire colon and rectum in patients with ulcerative colitis. A patient would have to use a colostomy bag for the rest of his or her life. No more: New techniques such as ileal pouch anal anastomosis can create part of the rectum. In a two- or three-stage procedure, the surgeon can fashion a new rectum using healthy intestine, and reconnect to the anus so that the patient’s daily life is minimally affected.

Although about half of people with Crohn’s disease will require surgery at some point, the procedure won’t be curative unlike ulcerative colitis. In some cases a patient may need more than one operation. The goal of the procedure is to remove the damaged portions of the digestive tract and reconnect the healthy sections. With the right medications and a careful eating plan, patients may be able to avoid a return of their symptoms.

People with IBD can find excellent information and support through groups such as the Crohn’s and Colitis Foundation of America www.ccfa.org. Just remember that it’s key to seek treatment early, no matter how unpleasant it may seem to discuss your symptoms. You’ll have many more options for treatment and much greater success.

Editor’s Note: Elie Abemayor, MD is the Chief of Gastroenterology at Northern Westchester Hospital.

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Care and Comfort for the Common Cold

Posted on: December 15, 2015

Care and Comfort for the Common Cold

By Dr. Elliot Barsh

Sneezing and coughing, symptoms of the common cold, are prevalent throughout the winter, and not surprisingly. According to the Centers for Disease Control and prevention, children average about six to eight colds each year. Understanding the symptoms, listening to your child and knowing when to see your doctor will help you provide the care and comfort your child needs.

The first thing to know about colds is that they’re caused by a virus, and that’s why doctors do not prescribe antibiotics in these instances, as they only work for bacterial infections. In fact, most of the symptoms you get with a cold—coughing, sneezing, fever—are your body’s way of fighting off the virus. It’s often a parent’s first instinct to treat the symptoms, but the cough and fever are therapeutic. Trying to suppress cold symptoms with medications can actually prolong the illness, and no one wants to feel sick longer than they have to. If your child is feeling miserable, by all means, give her Tylenol. If she seems to be feeling fine, there is no need to give her medicine. The key: Listen to your child and manage what she feels, by doing this you will be able to provide her comfort and help her body heal faster.

Colds last about 10 to 14 days. You’ll have two to three days of getting sick, possibly followed by a fever for three or four days, coughing may worsen over the next three or four days, and then you should see improvement over the last two to three days. It’s important to know that this pattern is not true of more serious infections, such as the flu and pneumonia, and I strongly recommend all children get the flu vaccine.

With colds, the plan is to get plenty of fluids, rest and sleep, and nourish your child back to health. Antibiotics don’t help speed recovery from the common cold. If your child seems run down or low on energy, make sure she stays home from school, play dates and sports practices. You can keep your child more comfortable by running a humidifier in her room at night. Dry air from heating can make coughs worse. I also recommend feeding your children plenty of citrus fruits. Vitamin C can help fight the virus, and the actual fruit is better than juice or pills because the fiber in the pulp delivers extra health benefits. And chicken soup, it’s not just an old wives’ tale, it’s actually medicinal. Should the symptoms get worse instead of better, persist longer than 10 days or seem more severe than the typical cold, call your doctor.

We can’t prevent our kids from getting sick, but we are able to reduce the frequency by reminding them to wash their hands well and often, and by teaching them to cough and sneeze into their elbows. Respiratory droplets expelled through coughing, sneezing and talking are how colds spread. Lastly, it turns out mom was right: keep the kids bundled up, if they’ve been exposed to the cold virus, they may be less likely to develop a cold. Simply remember, don’t treat the symptoms, treat your child, and speak with your doctor when you need to.

Editor’s Note: Elliot Barsh, MD, is a pediatrician at Northern Westchester Hospital and the Mount Kisco Medical Group as well as the school physician for the North Salem Central School District.

The Clever Cook: Back to School Lunchbox Learning

Posted on: September 8, 2015

The Clever Cook: Back to School Lunchbox Learning

By Amy Rosenfeld

Getting in the back-to-school swing after a relaxing, stress-free summer might be difficult, but Banana Sunbutter Sushiit’s definitely doable. Here are some tips to get lunchbox organized:

1) Start a lunchbox meal planner and start a rotation. It may sound silly but taking the task of thinking of ideas out of your daily routine is a real time saver.
2) Get organized with great lunchbox materials. Stock up on a variety of portable containers, including many sizes for hot and cold packing.
3) Make recipes ahead and freeze. As much as you can do ahead of time, the better off you will be. One way to get started: make soups ahead and freeze in ice cube trays for easy defrosting.

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Summer Safety Tips

Posted on: August 5, 2015

Summer Safety Tips

By Dr. Peter Richel

Keeping children healthy and safe through the summer months takes preventive measures. ChildreYoung Family Parents and Boy Son Cyclingn should wear protective gear for whatever activity they may be engaged in—helmets for biking and skateboarding, life jackets for swimming, and so on.

However, there is safety gear for activities you may not consider dangerous. Because ticks are such a concern, I recommend children wear shoes, socks, light pants tucked into the socks, and long sleeves when hiking in the woods. Clothing can be sprayed lightly with Deep Woods Off—but it’s too strong to use directly on children’s skin. For the skin, parents can apply Skintastic or Avon Skin-So-Soft with good repellent quality and demonstrated safety. (However, don’t use these on infants less than 6 months of age.) The best prevention is in daily tick and rash checks—just line up the kids at bath time!

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Surprising Findings for Infants at Risk for Peanut Allergies

Posted on: July 29, 2015

Does early introduction of peanut products reduce the incidence of peanut allergy?

By Dr. Craig Osleeb

Creamy Peanut Butter with PeanutsPeanut allergy is a major problem. It is currently one of the 6 most common causes of food allergy in childhood. The prevalence of peanut allergy has risen over the past decade and currently affects approximately 1.4% of the USA population. While many children will outgrow their food allergy to milk, egg, wheat and soy, 82% of those allergic to peanut will remain so for life. This is a great concern to parents, patient’s and the healthcare community at large. In February of this year the New England Journal of Medicine published a prospective placebo blinded study (Learning Early about Peanut Allergy, LEAP, study) that has far reaching implications for the prevention of peanut allergy.

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