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Pediatric Gastroenterology and Obesity

When it comes to pediatric gastroenterology, you can count on GI4kids. As the leader in pediatric gastroenterology in East Tennessee, GI for Kids prides itself on offering you and your children the best advice and the finest services in Knoxville and the surrounding areas.

One of the issues the GI4kids pediatric gastroenterology physicians and dietitians deal with is childhood obesity from physical inactivity and a poor diet.

Physical activity is an important component of health and well-being for people of all ages. Children who are physically active may gain immediate and long-term positive effects, such as improved mental health and self-esteem, enhanced performance of daily activities, promotion of bone formation, weight management, and prevention of cardiovascular risk factors.

Today, screen time has been on the rise when it comes to a child’s preferred daily recreation. It is estimated that children in the United States spend 25% of their waking hours watching TV, using the computer, and playing video games as their leisure time.  The American Academy of Pediatrics notes that children who watch five or more hours of TV per day have four-and-a-half times greater risk of being overweight than those who watch two hours or less.

In addition to inactivity, children today have an unhealthy diet that includes more fast foods, sugar-sweetened drinks, and not eating breakfast. Fast food is ready-to-eat, low cost, and easy to take home and serve. Having less nutritional value and much higher in calories, this diet produces more overweight and obesity in children.

In 2007, The American Academy of Pediatrics, recommended avoiding sugar-sweetened beverages, reducing portion sizes, eating 5 to 9 fruit and vegetable servings a day, at least 1 hour of moderate to vigorous physical activity a day, eating breakfast, a maximum of 2 hours of TV, and eating less fast food to reduce the risk of children becoming overweight and obese.

For more information regarding childhood and adolescent obesity, talk to the pediatric gastroenterology professionals from GI for Kids who can help you come up with a plan to keep your kids and teens fit for life.

Pediatric Gastroenterology

Our clinic doesn’t follow the trends, it sets them! GI for Kids is a patient-centered clinic offering pediatric gastrointestinal, hepatology and nutritional services. When a child says “my tummy hurts,” it can be a lot of different things. From intake to diagnosis and beyond, we work with patients and their families to treat GI illnesses, weight issues, mental-health challenges and much more.

Gastrointestinal (GI) bleeding is among the most common gastrointestinal disorders and can range from microscopic bleeding to massive bleeding leading to hypovolemia and shock. In children, GI bleeding requires prompt assessment, diagnosis, and treatment. Two issues should be addressed immediately: the child’s appearance, mental status, blood pressure and heart rate, and the likelihood of ongoing bleeding. It is important to determine whether the bleeding is from an upper or lower GI source because this will help in the diagnosis and treatment.

Many things children eat can look like blood. Red food coloring found in foods like Jell-O or Kool Aid, as well as fruit juices and beets may resemble blood, if vomited. Melena may be confused with dark or black stool from iron supplementation, bismuth subsalicylate, dark chocolate, grape juice, spinach, cranberries, or blueberries. A simple Hematest performed at the bedside can confirm presence of blood in gastric contents or in stools. In the neonate, the Apt test will differentiate maternal from infant blood.

An upper or lower endoscopy can be used to evaluate GI bleeding and is the procedure of choice for a diagnosis; and sometimes used in emergency cases. Where endoscopy is non-diagnostic, a bleeding scan, Mickel’s Diverticulum Scan, Capsule Endoscopy or Angiogram can be used. We have a state of the art endoscopy suite located at East Tennessee Children’s Hospital that is supported by multiple pediatric specialists that include surgeons, anesthesiologists, intensive care specialists, radiologists, hematologists, and other specialists on call, as needed, to help our team manage and care for these patients.

KidsFACT Newsletter “Poop Scoop”

Over the years of serving pediatric patients, we have seen more patients with a chronic disorder called Inflammatory Bowel Disease, which includes both Crohn’s and Ulcerative Colitis. While the exact cause is unknown, it may affect any age, males and females, and, while it can affect one child, it often runs in families. Realizing the great need for families affected by this disease to have a place to come together in a casual setting to share stories, talk about treatments, and support each other, Dr. Youhanna Al-Tawil, through the GI for Kids clinic, started this non-profit group called KIDSFACT.

The mission statement defines this non-profit group. On a daily basis, KIDSFACT strives to improve the quality of life and advance the latest information on IBD to better treatments and ultimately some day to a cure. KIDSFACT raises awareness through sponsoring educational seminars, fundraising events, family activities, and research opportunities. A newsletter will be another avenue to reach these patients and families, as well as broaden its mission to the community. The roll-out of the first issue of “Poop Scoop” is scheduled for April, 2015. Please contact Ashley Treadway if you are interested in receiving this newsletter.

Drawing for Free Camp Oasis Summer Camp in April, 2015

KidsFACT is sponsoring (3) GI for Kids patients to attend this years Camp Oasis Summer Camp Program at Camp Will-A-Way in Winder, Georgia. The drawing will be held here on Monday, April 6, 2015. KidsFACT will provide the camp fee and a $200 travel allowance for the child. domain list . The family will be responsible for all transportation arrangements and camp registration.

For registration information go to website and then KidFACT events and meetings. Information on the camp, and all the details for attending the camp, visit the CCFA website: oasis/.

Summer Fast-Food Choices for Kids

Children today are eating more fast foods, more sugar-sweetened drinks, more snacks, and not eating breakfast. Fast food is ready-to-eat, low cost, and easy to take home and serve.  While fast food is considered to have less nutritional value and higher in calories, many of these restaurants are now working hard to improve their menus to offer more healthy foods.

It is summer, and children are out of school and families are involved in various activities outdoors. When it is time for lunch or dinner it may be easier to just stop at a fast food restaurant to pick up something.  One of the issues the pediatric gastroenterologists and dietitians at GI4kids prides itself on is offering parents and children the best information and advice on diet and exercise to prevent childhood obesity.

Below we have compared several foods we know kids love to eat—especially during the hot summer:

McDonalds – 240 calories, 12g protein, 8g fat
Burger King – 230 calories, 9g protein, 9g fat

*Ice Cream cones
McDonalds – 170 calories, 5g protein, 4.5g fat
Burger King – 160 calories, 4g protein, 4g fat
Chick-fil-A – 260 calories, 7g protein, 6g fat

*Chicken Sandwich
McDonalds – 370 calories, 14g protein, 17g fat
Burger King – 640 calories, 29g protein, 36g fat
Chick-fil-A – 440 calories, 28g protein, 18g fat

*French Fries
McDonalds – 230 calories, 2g protein, 11g fat
Burger King – 190 calories, 2g protein, 8g fat
Chick-fil-A – 310 calories, 3g protein, 16g fat

*Chicken nuggets
McDonalds – 190 calories, 9g protein, 12g fat
Burger King – 190 calories, 8g protein, 11g fat
Chick-fil-A – 270 calories, 28g protein, 13g fat

At GI for Kids, we offer a weight management program, Bee Fit 4 Kids, that can help parents and children learn healthy dietary habits and increasing their physical activity.


*Information taken directly from restaurant menus.

Family-friendly Nutrition for Summer

What children need to eat for good health and a healthy weight isn’t all that different from adults. Creating healthy meals for the entire family, using a nutritious diet, should include fruits, vegetables, whole grains, lean protein, fish, beans, and low-fat or fat-free dairy.

Make it a family affair. Work on improving the diet of everyone in the family. Keeping calories under control during the summer can be fun. As the weather gets warmer, and everyone is spending more time outside, think of ways to use the grill, microwave, or even a slow-cooker.

Traditional barbeque includes foods like hot dogs, hamburgers and chicken. When grilling, think about ways to make the meal healthier:
Cut the fat. Grill turkey burgers.  Ground turkey can be as lean as 99% fat-free.  Ground beef that is 93% lean is also a good choice.  The same for hot dogs. There are now many options for lower fat or fat-free hot dogs using lean meats or turkey.
Add nutrition to the meal. Cook veggies on the grill. Baste vegetables like zucchini, corn, peppers or tomatoes and add herbs for a great new taste.
Change up what’s for dessert. Grill fruit like pineapple or peaches. Our vehicle locksmiths repair car locks on all types of cars Serve them on top of low-fat ice cream, yogurt, or angel food cake

Turning on the stove is not necessary to make a good, nutritious meal. Try using household gadgets. A sandwich press can make nutritious hot sandwiches. A rice cooker can be used to make rice, quinoa or millet that can be eaten as a side dish, or added to a salad for added texture. The microwave can prepare veggies like potatoes, broccoli and carrots.  A crock pot (slow cooker) can be used to keep the heat down in the kitchen and less time cooking.

Other information can be found on

Pediatric Gastroenterology Specialists in East Tennessee

Serving the East Tennessee and the surrounding areas, GI for Kids PLLC is proud to be the premier pediatric gastroenterology group in the state. Providing the best care for babies, children and teenagers, our pediatric gastroenterology group understands that children are not small adults. As a child’s body grows, each has unique medical needs and will express concerns much differently than adults. It is hard for children to answer questions and can sometimes find it difficult to be cooperative and patient.

The pediatric gastroenterology specialists at GI for Kids PLLC focus on the unique problems that may occur with pediatric patients including emotional and physical development, maturation, and growth. Some of the treatments available include lactose intolerance, gastrointestinal tract bleeding, inflammatory bowel disease, severe gastroesophageal reflux, liver disease, chronic or acute abdominal pain, vomiting, chronic constipation or severe to chronic diarrhea. Du vil få informasjon om hva et online casino er, og hvordan de typiske casinoene fungerer her hos casinonorske.

Much has changed in the last decade or so with more children dealing with obesity. A pediatric gastroenterology specialist is trained to help deal with nutritional problems and can provide you and your kids with a low fat diet or other dietary solutions to help teach your children how and what to eat.

If your child is experiencing symptoms that may be helped by a pediatric gastroenterology specialist, schedule an appointment with your pediatrician or family physician today.

Pediatric Gastroenterology and Milk Hypersensitivity or Allergy

Milk protein hypersensitivity or allergy is a diagnosis often used in conjunction with breast milk, cow’s milk or soy milk to describe groups of symptoms seen in pediatric patients, including infants. At GI4 kids we have pediatric gastroenterologists and registered dietitians on staff who can intervene and provide support as needed.

The vast majority of infants with milk protein hypersensitivity are expected to outgrow their intolerance, whereas a handful of them may carry on their hypersensitivity into childhood. These may manifest different forms of food allergies. Automotive lockouts happen from time to time

For infants with a milk allergy, the pediatric gastroenterologist and dietitian may recommend a breastfeeding mother try a dairy free diet to see if the infant’s symptoms improve. If that is not successful, they may recommend a soy-based formula for the infant. If cutting out dairy and/or switching to a soy formula does not help, the infant may be switched to a hypoallergenic pre-digested or an amino acid-based formula.

For older children, eating and drinking real foods and liquids, avoiding milk may be necessary. Rice, almond, coconut or soy milk may be used instead of cow’s milk as long as the child is not allergic to the proteins in these other milks.

As the leader in pediatric gastroenterology in East Tennessee, GI for Kids prides itself on offering you and your children the best advice and the finest services in Knoxville and the surrounding areas. For more information, contact GI for Kids regarding milk hypersensitivity or allergy, or visit the website under the nutrition tab.

Pediatric Gastronenterologists Al-Tawil and Ammar voted Top Docs in 2015

Al-tawil and Ammar 017

Each year, Cityview magazine calls on working physicians in the Knoxville medical community to recognize what physicians they would recommend if they, a patient, or a loved one needed specialized care. Pokies, the Australian slang for slot machines, are now available for real money play across many online casinos throughout Australia play pokies for real money. According to City view:

“This is not a popularity contest or a paid survey, but rather the opinions of the practicing physicians on the front lines of the healthcare industry. Physicians offer a unique perspective on healthcare. While they are known to their patients as providers, physicians are also patients of their peers. They are both the healer and the healed. They see their profession from either side—and what could be more telling than that? In this year’s Top Docs listing, we recognize more than 400 physicians who have been honored by their peers as the most outstanding providers in their fields”.

Dr. Youhanna Al-Tawil and Dr. Samar Ammar are two gastroenterologists recognized as part of the Top Docs of 2015, and  two of the three gastroenterologists here at GIforKids.

Diagnosis for Helicobacter pylori in a pediatric population

By: Youhanna S. Al-Tawil, MD,  GiforKids, PLLC

H. pylori can be found in a normal stomach and be asymptomatic. When there is a strong suspicion that H. pylori are causing clinical symptoms, testing can not only detect the presence of H. pylori but also confirm a diagnosis.

Upper gastrointestinal endoscopy and biopsy remains the “gold standard” in the diagnosis and identification of H. pylori infection and its consequences in childhood.  It allows visualization of the upper gastrointestinal tract.  Nodularity within the stomach is seen more frequently in children than adults.  The mucosa is irregular in appearance, resembling a cobblestone pavement.  Seen most often within the gastric antrum, it is frequently referred to an antral nodular gastritis.

Other tests that are not preformed thru endoscopy include the serologic (blood prick) test.  In children, this test detects only 20-50% of H. pylori infected patients.  The urea breath test can be done safely in the clinic and is used to detect H. pylori in young children; and can be repeated without risk to the child.  H. pylori antigen can also be detected in the stool.  Stool testing is a potentially inexpensive, non-invasive method for determining H. pylori infection. If you are looking for trustworthy and reliable company to care for your heating and ac repair service needs, you’ve come to the right place  Overall sensitivity and specificity of the stool test are comparable to the breath test.  The sensitivity to stool testing is negatively affected by PPLs, bismuth, and antibodies, which can decrease bacterial load.