For the past 10 years, Gentiana and her family have searched for answers to chronic gastroenterological issues she has dealt with since birth. As an infant, Gentiana suffered from gastroesophageal reflux disease (GERD). Since then, she has seen a number of pediatricians, and her symptoms included difficulty swallowing, an itchy throat, abdominal pain and poor appetite. Each time, her doctors prescribed medications to help relieve the symptoms, but the issues never really went away.
That is, until she met Aakash Goyal, M.D., Children’s Health℠ Pediatric Gastroenterologist and Assistant Professor of Pediatrics at UT Southwestern.
“After discussing Gentiana’s symptoms with her pediatrician, we were referred to the GI program at Children’s Health, which is where we met Dr. Goyal and his wonderful team,” her mom Amanda says. “I knew immediately that he was a sincere and caring physician who understood my concerns and wanted to help figure out the actual cause of her issues.”
Dr. Goyal performed an upper endoscopy and biopsy to examine her esophagus, stomach and small intestine and diagnosed Gentiana with lactose intolerance and eosinophilic esophagitis (EoE), which is an allergic inflammation of her esophagus.
A food elimination diet leads to positive results
Over the next three months, Gentiana eliminated all lactose from her diet, which relieved some of her symptoms, but not all. After a second endoscopy revealed that her esophagus was still inflamed, she was referred to Christopher Parrish, M.D., Assistant Professor in the Departments of Pediatrics and Internal Medicine at UT Southwestern. Dr. Parrish and Dr. Goyal serve as Co-Director of the Dallas Eosinophilic Esophagitis Program (DEEP) at Children’s Health.
After a skin panel test came up negative for any food allergies, Gentiana and her family were faced with a choice: begin a steroid regimen or start an elimination diet. They chose the latter.
“Over the next six months, we cut out soy, egg, fish, gluten and [cow’s milk] from Gentiana’s diet and eliminated processed foods as much as possible,” says Amanda. “It was a major lifestyle adjustment and she wasn’t happy that she couldn’t have her deviled eggs or tuna fish, but she adjusted well after the first week.”
Fortunately, Gentiana’s symptoms disappeared and a third endoscopy showed that her EoE had cleared up. Over the next several months, Gentiana will add one food item at a time back to her diet, and return every three months for a scope to watch for allergic inflammation.
The first food to be added back? Eggs, of course!
“Talk about a happy child to have her deviled eggs back,” Amanda says. “And she can now enjoy eating without fear of her throat feeling like it will close up.”
Gentiana is scheduled for a third endoscopy at the end of the year; if given the “all clear,” she will continue to add additional items back to her diet until they can identify what has been triggering the EoE.
Throughout it all, Amanda says that her daughter has received great care at Children’s Health and feels so grateful for Dr. Goyal’s expertise and compassion throughout Gentiana’s journey.
“My daughter has been through a lot,” she says. “But Dr. Goyal has been amazing.”
The Dallas Eosinophilic Esophagitis Program (DEEP) at Children’s Health is a multidisciplinary clinic for patients with eosinophilic esophagitis (EoE) that is led by Co-Directors Christopher Parrish, M.D., and Aakash Goyal, M.D. Patients will be seen by a multidisciplinary team that includes UT Southwestern pediatric gastroenterologists, an allergist, a dietitian and psychologist. For more information, call 214-456-8000.
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