Gastroenterology and GI Surgery Research

The cover of Pediatric Colorectal Conundrums, Case Studies: From Fundamental to Advanced

New case-based textbook explores complex pediatric colorectal care from fundamentals to advanced management

February 23, 2026

The cover of Pediatric Colorectal Conundrums, Case Studies: From Fundamental to Advanced.

A new textbook, Pediatric Colorectal Conundrums, Case Studies: From Fundamental to Advanced, authored by Marc Levitt, MD, chief of the Division of Colorectal and Pelvic Reconstruction at Children’s National Hospital, is now available. The publication marks Dr. Levitt’s sixth textbook and brings together global expertise to guide clinicians through the full spectrum of pediatric colorectal and pelvic reconstructive conditions. He is joined by co-authors Thomas Xu, a fellow in colorectal surgery at Children’s National, and Hussein Wissanji, who runs the colorectal program at the Montreal Children’s Hospital

What is it?

Through a case-based format, the book reflects the real-world experiences of contributors from around the world and emphasizes practical decision-making, functional outcomes and long-term quality of life for patients. Illustrated and complemented by online resources, the text serves as both a foundational reference and an advanced clinical guide.

The cases originated from a weekly quiz that Dr. Levitt distributed to colleagues around the world during the pandemic. Each Monday, a new case would arrive via email, inviting surgeons to submit their diagnoses and management plans, with the correct answer shared the following week.

At a time when COVID-19 halted in-person meetings and disrupted traditional academic forums, this initiative helped sustain meaningful exchange and professional connection. It was from this highly engaged, global series that the concept for the book ultimately emerged.

The first section provides guidance on the evaluation and management of core conditions, including:

Male and female anorectal malformations
Cloaca
Hirschsprung disease
Functional constipation

The second section moves into challenging and nuanced scenarios, offering alternative strategies for complex presentations and complications. Topics include:

Advanced anorectal malformation cases and surgical approaches
Cloaca case variations
Complications of Malone appendicostomy
Difficult Hirschsprung disease cases
Colonic motility disorders
Miscellaneous colorectal diseases such as atresias, duplications, prolapse, volvulus and urogenital sinus conditions

Why it matters

Children with anorectal malformations, cloaca, Hirschsprung disease, fecal incontinence and colonic motility disorders often require coordinated, lifelong care from multidisciplinary teams. This textbook underscores the collaborative nature of pediatric colorectal and pelvic reconstruction, highlighting the roles of colorectal surgery, urology, gynecology, gastroenterology motility, orthopedics, neurosurgery, physiotherapy, anesthesia, pathology, radiology, psychology, social work, nutrition and nursing.

By pairing foundational instruction with advanced case discussions, the book aims to standardize and elevate care worldwide, helping clinicians approach both common and rare scenarios with greater confidence and clarity.

A leader in pediatric colorectal surgery

Dr. Levitt is a world-renowned pediatric colorectal surgeon with expertise in treating the full spectrum of pediatric colorectal conditions. Over the course of his career, he has performed more than 15,000 surgeries – more pediatric colorectal operations than any other surgeon worldwide. In the past 25 years, his experience includes more than 2,500 posterior sagittal anorectoplasties, 1,000 cloacal reconstructions, over 1,000 Hirschsprung pull-through surgeries and more than 500 Malone appendicostomies.

Through this sixth textbook, Dr. Levitt continues his longstanding commitment to education and global knowledge sharing, equipping surgeons and multidisciplinary care teams with practical tools and real-world insights to improve outcomes for children everywhere.

Order a copy of Pediatric Colorectal Conundrums, Case Studies: From Fundamental to Advanced.

U.S. News & World Report voting

February 3, 2026

Children’s National is ranked one of the top 10 pediatric hospitals in the nation by U.S. News & World Report. Our faculty and staff are proud of the impact made on the lives of children and families in our community. Your participation in the U.S. News & World Report annual reputational survey validates the quality of care we provide and reflects the mutual respect and trust we share as healthcare professionals.

How to determine your voting eligibility

Voting for the U.S. News & World Report Best Children’s Hospitals rankings can be done only through Doximity.

To participate, physicians must:

Be board-certified and meet the eligibility criteria for the voting categories.
For child and adolescent psychologists, your account must be up to date with your specialty and subspecialty correctly marked.
Be a credential-verified member of Doximity (you must have an active and claimed Doximity profile).
Have all certifications and board documents currently up-to-date in your Doximity profile.

View the full eligibility criteria

How to claim your Doximity profile to vote

You have to claim your profile on Doximity.com to participate in the online survey. If you have not yet claimed your Doximity profile, go to Doximity.com, and click “Find My Profile.”
Once your profile has been claimed, you must confirm your email address and board certifications.
Verified Doximity members will receive an email inviting them to participate in the U.S. News survey.
For more information on how to claim your profile, visit Doximity.com

How to update and verify existing Doximity account information

Your Doximity profile must have up-to-date licenses, certifications and board documents.

Once you are logged in, your profile will automatically be in “Edit Mode.” You are able to add new items or edit existing information.
Update your Doximity profile and ensure your information is current.

Once registered, users wishing to participate in the online survey should:

Watch for an email from Doximity about the annual member survey.
Even if you don’t see the email, if you are a registered Doximity user, you can still vote by logging in to Doximity.com with your username and password during the voting period.
Once logged in, look for a U.S. News graphic or button on the homepage and click on it.
The survey asks users to name the hospitals that provide the best care in your respective specialty, without consideration to location or cost. Pediatric specialists will list 10 hospitals. The order in which you list the hospitals does not matter.

Please note: Children’s National Hospital is listed as “Children’s National Hospital Washington, DC” on the survey.

Visit Doximity’s FAQs if you have issues or questions about registration or claiming your profile.

How to cast your vote

In February 2026 when voting opens, all survey-eligible physicians will receive a notification on the Doximity app for Android or iOS. If you do not use the Doximity app, you will receive an email when voting opens.

Log in to your Doximity account at doximity.com or via the mobile app.
Click the Notifications icon or tap the “Submit your Nominations” button on the homepage. You can also search for “U.S. News Best Hospitals”
Select 10 hospitals in your respective specialty that you believe provide the best care in the United States.
Submit your vote

Having technical issues?

If you have difficulty registering with Doximity or completing the survey, please visit Doximity support for assistance.

Vote

The 2026 U.S. News & World Report Best Children’s Hospitals reputation voting will open in mid-February. Look for your Doximity notification to vote.

Cast your vote

Advances in celiac disease diagnosis: Q&A with Dr. Vahe Badalyan, MD

February 2, 2026

A recent study published in Pediatrics suggests that serologic testing may allow some children to be diagnosed with celiac disease without undergoing an invasive endoscopy when antibody levels are very high.

For many years, pediatric celiac disease diagnosis in North America has relied on an endoscopy and biopsy-based approach designed to maximize diagnostic certainty. In contrast, international guidelines have evolved to incorporate non-biopsy diagnostic pathways for selected patients. Experts at Children’s National Hospital, working with colleagues across the United States and Canada, sought to determine whether a non-biopsy approach—based on very high blood markers—could be safely and reliably applied to children in North America.

A recent study published in Pediatrics suggests that serologic testing may allow some children to be diagnosed with celiac disease without undergoing an invasive endoscopy when antibody levels are very high. The study found that tissue transglutaminase IgA (tTG IgA) levels elevated to 10 times the upper limit of normal or higher predicted celiac disease in approximately 95% of children. However, diagnostic accuracy varied across testing assays from different manufacturers. These findings underscore the importance of specialist evaluation and confirmatory testing before starting a lifelong gluten-free diet.

In this Q&A, Vahe Badalyan, MD, pediatric gastroenterologist and medical director of the Children’s National Celiac Disease Program, explains how this research is informing evolving diagnostic guidelines and helping ensure accurate diagnosis while minimizing unnecessary procedures and dietary restrictions.

Vahe Badalyan, MD

Q: How does this work move the field forward?
A: Updated North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) guidelines for pediatric celiac disease diagnosis are long overdue, and this study will serve as an important reference. This work provides the largest North American dataset to date evaluating how well tTG IgA testing performs in diagnosing celiac disease in children, addressing a critical evidence gap that has limited guideline development. By directly comparing multiple commonly used assays, the study demonstrates substantial variability in test performance and challenges the assumption that very high tTG IgA levels alone are sufficient for diagnosis in all cases.

Q: How has collaboration with experts nationwide created better outcomes for this research?

A: Studies like this require large patient populations, which are difficult for any single center to assemble. This multicenter group of clinicians and researchers has collaborated for several years and has published work on multiple aspects of celiac disease. Children’s National has been an active participant in the NASPGHAN Celiac Disease Special Interest Group, which includes many of the centers and authors involved in this study. This collaborative framework made it possible to generate robust, generalizable data.

Q: How will this work benefit patients?

A: These findings support a more individualized, patient-centered approach to diagnosing celiac disease. While endoscopy with biopsy is a safe and well-established procedure, families value having evidence-based alternatives when appropriate. At the same time, a lifelong gluten-free diet carries substantial mental, emotional, social and financial burdens for patients and families. This research reinforces the importance of making the diagnosis only when we are confident it is correct.

Our results emphasize that children with elevated tTG IgA levels should be evaluated by a pediatric gastroenterology specialist and undergo confirmatory testing before a diagnosis is made and a gluten-free diet is started. By improving diagnostic accuracy, this work helps ensure that children are placed on lifelong dietary therapy only when they truly have celiac disease, avoiding unnecessary restrictions and burdens for those who do not. Importantly, it also highlights the need for continued research to refine and improve diagnostic pathways.

Other Children’s National experts who contributed to this work include Catherine Raber, MA. Read the full study ‘Positive Predictive Value of Tissue Transglutaminase IgA for Celiac Disease’ in Pediatrics.

The best of 2025 from Innovation District

December 24, 2025

In 2025, Innovation District readers gravitated toward stories that explored how research and clinical innovation are reshaping pediatric care in real time. This year’s most popular articles highlighted advances in complex surgical care, evidence-based treatments for chronic and neuropsychiatric conditions and emerging technologies — from wearable data to artificial intelligence — that are changing how clinicians diagnose, treat and support children and families. Read on for our list of the most popular articles we published on Innovation District in 2025.

1. Life-changing care: How Children’s National tackles pediatric cervical spine injuries

The Cervical Spine program at Children’s National Hospital is responsible for treating a range of conditions, including trauma, congenital abnormalities and tumors. These conditions can lead to instability or misalignment of the cervical spine. “There are unique challenges in pediatric cases due to anatomical differences. The cervical spines of children are more at risk for injury because of their developmental stage and structural characteristics,” says Matthew Oetgen, MD, MBA, chief of Orthopaedic Surgery and Sports Medicine at Children’s National.
(2 min. read)

2. Pioneering evidence-based treatments for substance addictions

Increasing evidence-based treatment is a key component of the Addictions Program at Children’s National Hospital, created in 2022 and led by Sivabalaji Kaliamurthy, MD. “We really want to focus on intervening in an evidence-based manner in the primary care setting because that is where most of our patients are going to first access care outside of the emergency room,” explains Dr. Kaliamurthy.
(3 min. read)

3. Breaking barriers in growth disorder treatment for families

For many children with short stature and other rare genetic growth disorders, there have been no next steps after usual treatment options prove ineffective. Researchers at Children’s National Hospital are digging deeper to find the root genetic causes of short stature disorders and creating novel, nuanced treatment options that have the opportunity to change how the field approaches these cases.
(4 min. read)

4. The link between metabolic acidosis and cardiovascular disease in children with CKD

Denver D. Brown, MD, nephrologist at Children’s National, is looking at whether untreated metabolic acidosis could potentially contribute to cardiovascular outcomes in children with chronic kidney disease (CKD). Here, she explains her motivation, findings and future directions for this critical research.
(3 min. read)

5. Therapy approach shows promise for PANS/PANDAS

A multidisciplinary therapy model developed at Children’s National shows promise for children with PANS and PANDAS, significantly reducing symptoms through structured cognitive-behavioral therapy and family-centered care. The approach could offer a new standard for treating these rare, complex neuropsychiatric disorders.
(2 min. read)

6. Wearable tech data shows promise in ADHD detection

A study from Children’s National reveals that common wearable devices like Fitbits may hold the key to improving how we identify Attention-Deficit/Hyperactivity Disorder (ADHD) in adolescents. By analyzing patterns in heart rate, activity levels and energy expenditure, researchers were able to predict ADHD diagnoses with striking accuracy, offering a glimpse into a future where objective, real-time data supports earlier and more personalized mental healthcare.
(2 min. read)

7. Novel pediatric pacemaker shows safety, effectiveness for fragile infants in multi-center study

A novel implantable pacemaker designed specifically for infants has demonstrated safety and effectiveness in stabilizing heart rhythms for at least two years. The multi-center study of 29 infants showed stable pacing, normal electrical parameters and expected battery life, offering a viable alternative to standard-size devices for the smallest children.
(2 min. read)

8. Socioeconomic disadvantage associated with higher long-term mortality for children after heart surgery

Children who had heart surgery and come from less advantaged neighborhoods in the Washington, D.C., region are much more likely to die in the long term than those from neighborhoods with more wealth and opportunity. The finding was part of a presentation titled, Socioeconomic Disadvantage Is Associated with Higher Long-Term Mortality After Cardiac Surgery, by Jennifer Klein, MD, MPH, cardiologist at Children’s National Hospital, during the Society of Thoracic Surgeons Annual Meeting in Los Angeles.
(2 min. read)

9. Children’s National brings AI into the RHD early diagnosis equation

Experts from Children’s National traveled to Uganda to continue work on a pilot program applying artificial intelligence (AI) to the diagnosis of rheumatic heart disease (RHD). The team created a tool that uses AI to predict RHD by identifying leaky heart valves on handheld ultrasound devices, then prompts a referral for a full echocardiogram.
(2 min. read)

10. Fighting food insecurity with fresh produce and education

Food insecurity is rising in Washington, D.C. and it’s hitting families with children the hardest. That’s why Children’s National Hospital created the Family Lifestyle Program (FLiP) – a multi-layered intervention, which offers Patient Navigation (FLiP-PN) and a Produce Prescription Intervention (FLiPRx). FLiP is a Food Is Medicine, clinical-community initiative that helps families get access to fresh food, build healthy habits and lower their risk of diet-related diseases like diabetes and obesity.
(3 min. read)

Children’s National in the News: 2025

December 23, 2025

In 2025, Children’s National Hospital was featured in major national news outlets for pioneering advances in pediatric care, groundbreaking clinical research and powerful human stories of healing and hope. From gene therapy for sickle cell disease and innovative pacemakers for newborns to breakthrough transplants, cancer trials and emerging mental health concerns like AI psychosis, these stories highlight the hospital’s leadership across the full spectrum of pediatric medicine. The following ten highlights showcase the patients, families and experts behind this impact, as reported by outlets including NBC News, The Washington Post, Good Morning America, USA Today, Healio, ABC News and ESPN.

1. Gene therapy treatment gives new hope to sickle cell patients

Children’s National patient Wedam, 19, begins the first steps for intensive gene therapy for sickle cell disease, discussing his skepticism while his mother expresses her joy and gratitude for the treatment. (NBC News)

2. Little pacemakers ‘reliable’ in stabilizing newborns needing pacing

Charles Berul, MD, pediatric electrophysiologist and emeritus chief of Cardiology, discusses his study highlighting the safety and efficacy of an innovative smaller pacemaker designed for newborns with critical congenital heart disease. (Healio)

3. Why this clinical trial is offering some young cancer patients hope

Catherine Bollard, MBChB, MD, senior vice president and chief research officer, and the NexTGen team are poised to recruit patients for a new clinical trial that will take on an old, implacable foe: children’s solid tumors. (The Washington Post)

4. 11-year-old receives living donor heart valve to replace artificial one in breakthrough surgery

Yves d’Udekem, MD, PhD, chief of Cardiac Surgery, talked to Good Morning America about how an 11-year-old’s groundbreaking partial heart transplant will change his life and the lives of other children in need of valve replacements. (Good Morning America)

5. 9-year-old fights brain cancer with magic in her heart

The Lilabean Foundation along with Brian Rood, MD, medical director of the Brain Tumor Institute, talked about how patients like Kasey Zachman are the motivation behind finding a cure for brain cancer. (ABC News)

6. How Little League helps father-son duo recover from kidney transplant

USA Today Sports spoke with Gavin Brown and his parents, as well as Yi Shi, MD, a pediatric nephrologist at Children’s National Hospital, about their kidney transplant journey. (USA Today)

7. Jayden Daniels surprises Children’s National patient

After Jayden Daniels visited Commanders fan Sarah Addison at Children’s National Hospital while she was being treated for myeloid leukemia, they quickly became friends. (ESPN)

8. At D.C. children’s hospital, opera singers offer light, hope and healing

International opera stars performed for children, their families and employees at Children’s National Hospital. (The Washington Post)

9. ‘Gift of life:’ Tiny heart transplant saves life of Maryland baby

A baby boy in Maryland is back home after being given a second chance at life, just before his first birthday. The boy’s mother and his surgeon, Manan Desai, MD, share the remarkable story of a moment that changed all of their lives. (NBC4)

10. AI psychosis: Kids left delusional and paranoid over conversations with chatbots

Ashley Maxie-Moreman, PhD, clinical psychologist, spoke to ABC7 about what AI psychosis is and what parents need to know. (ABC7)

Advancing pediatric GI care: Children’s National at the 2025 NASPGHAN Conference

November 17, 2025

In early November, doctors, fellows and faculty from the division of Gastroenterology, Hepatology and Nutrition at Children’s National Hospital attended the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) conference in Chicago.

The annual conference brings together experts from across the nation to discuss and learn about normal pediatric development and how pediatric gastrointestinal, liver and nutritional disorders can disrupt it.

Presenters and topics from Children’s National included:

Receptions & Concurrent Sessions

Diana Moya, MD, program director: Fellowship program reception
Ian Leibowitz, MD: Show Me the Money! Unlocking Your Financial Potential. Mastering the Negotiation Game – Tactics for Success.

Poster Presentations

Diana Jo, MD, Nathan Bryan, DO, Christopher Hayes, MD: Just around the bend: An elusive case of dysphagia lusoria in a young boy.
Udeme Ekong, MBBS MD, Khalid Khan, MD, Kimberly Chapman, MD, Carolina Rumbo, MD, Nada Yazigi, MD: Long term risk for metabolic syndrome in pediatric liver transplant recipients with metabolic disorders: A retrospective clinical chart review.
Brenna Hohl, DO, Migseg Sanchez, DO, Diana Moya, MD: Bronchiolitis obliterans organizing pneumonia in a pediatric patient with Crohn’s disease: A rare extra-intestinal manifestation.
Catherine Raber, Shayna Coburn, PhD: Feasibility and acceptability of routine weekly at-home gluten immunogenic peptide testing in teens in a 6-week behavioral intervention for celiac disease.
Catherine Raber, Vahe Badalyan, MD: Clinical outcomes of children with potential celiac disease in North America: A multicenter retrospective study.
Christopher Hayes, MD: Therapeutic trial of Sucraid® (sacrosidase) for alleviating gastrointestinal symptoms in pediatric subjects stratified by duodenal sucrase activity levels.
Migseg Sanchez, DO, Jyoti Mani, MD: Occult esophageal foreign body identified during evaluation of chronic vomiting in a toddler.
Serena Haver, MD, Diana Jo, MD, Otto Louis-Jacques, MD: Evaluating the impact of swallowed topical steroids on growth in children with eosinophilic esophagitis.
Nathan Bryan, DO, Kibileri Williams, MBBS, Diana Moya, MD, Christopher Hayes, MD: Predictors for readmission in newly diagnosed pediatric inflammatory bowel disease.
Vahe Badalyan, MD, Clarivet Torres, MD: Management of small intestinal bacterial overgrowth (SIBO) in pediatric short bowel syndrome (SBS).
Joi McLaughlin, MD, Christopher Hayes, MD: A rare case of diagnosis and endoscopic reduction of ileocecal intussusception secondary to Burkitt’s lymphoma.
Guy Ozigre, Vahe Badalyan, MD: Endoscopic success: avoiding surgery in an autistic child with multiple magnet ingestions.
Anil Darbari, MD, Ian Leibowitz, MD, Deepika Darbari, MD, Diana Jo, MD, Nathan Bryan, DO: Management considerations in patients with inflammatory bowel and sickle cell disease.

To learn more about the meeting, explore the NASPGHAN website for additional information.

endoFLIP displayed esophagogastric junction

POEM shown as preferable first-line surgery for pediatric achalasia based on 10-year outcomes

November 5, 2025

The surgeons use EndoFLIP measurements and appearance before and after POEM to gauge procedure effectiveness.

Peroral endoscopic myotomy (POEM) is a preferable first-line surgical intervention for pediatric esophageal achalasia, according to an analysis of 10-year outcomes for this procedure at Children’s National Hospital.

The single institution study evaluated clinical efficacy, safety, complications and durability of symptom relief based on data from 101 children who underwent 110 POEM procedures for achalasia from 2015 to 2025. The study group also included the largest cohort of children 10-years-old or younger who had this procedure ever reported in scientific literature.

Why it matters

Achalasia is a rare condition in adults and even less common in children, occurring in only 0.1 per 100,000 children annually and an estimated prevalence of 10 per 100,000. The rarity of achalasia in children has historically made collecting statistically significant evidence about how best to treat it difficult. However, as one of the first children’s hospitals in the country to offer POEM as the first-line treatment of these conditions in children, Children’s National has collected enough data in the last decade to conduct robust analysis for the first time.

Chief of General and Thoracic Surgery Mikael Petrosyan, MD, MBA, and his co-authors write, “Our results highlight the significant institutional adoption of this minimally invasive technique as a primary therapeutic intervention for achalasia in children. This aligns with previous pediatric studies documenting an increasing preference for POEM over traditional surgical interventions such as laparoscopic Heller myotomy (LHM), owing to its favorable procedural attributes and comparable outcomes.”

Additionally, the authors note, “Our institutional preference toward POEM clearly reflects both the accumulated expertise and documented advantages of POEM, including shorter hospital stays, reduced postoperative discomfort and superior or equivalent symptomatic outcomes.”

The study includes outcomes for the largest number of children 10 years of age or younger to undergo POEM procedures, showing the procedure is feasible and becoming more accepted in younger and smaller-sized patients. The cohort of younger children is also noteworthy because it includes those with complex genetic conditions, including Down syndrome, Triple A syndrome, GMPPA-CDG, MIRAGE syndrome and Sotos syndrome.

The authors point out that the success of procedures for this subgroup “underscores the adaptability, broad applicability and robust safety profile” of POEM for these patients.

Children’s National leads the way

Children’s National is one of the only children’s hospitals in the country to offer POEM for treatment of these conditions in children. Dr. Petrosyan and Timothy Kane, MD, director of the Thoracic and Foregut Program, combined perform more POEM surgeries than any other pediatric surgeons in the United States.

As the program with the most experience caring for and collaborating with this unique patient population, the doctors emphasize that surgical procedures are only one part of the puzzle. They write, “Optimal management of pediatric achalasia involves a multidisciplinary approach tailored to each patient’s clinical scenario, with the goal to maximize symptom relief, minimize procedural complications and enhance long-term quality of life.”

Read the full study, Pediatric Achalasia and Peroral Endoscopic Myotomy (POEM): Ten-Year Outcomes for 101 Children at a Single Institution, in the Journal of Pediatric Surgery.

Children at the the second annual Achalasia Awareness Night

Patients, families at the core of achalasia awareness and care

October 10, 2025

Children and young adults with achalasia, and their families, attended the second annual Achalasia Awareness Night at Children’s National Hospital, hosted by the pediatric surgery team.

More than 30 patients and their families recently attended Achalasia Awareness Night at Children’s National Hospital, a moving and empowering event led by Mikael Petrosyan, MD, MBA, and Timothy Kane, MD, with the dedicated support of the entire surgical team — including Jill Rafie, Segale Cephas and Rebecca Chavez.

“We are steadfast in our mission to provide not only world-class surgical care but also a strong network of support for families navigating achalasia,” Dr. Petrosyan said. “This event continues to set new standards for what is possible when patients, families and providers come together — united by compassion, collaboration and the shared goal of improving lives.”

What it means

The overwhelming turnout highlighted the importance of creating spaces where families can connect, learn and inspire one another. Smiles, tears and words of gratitude filled the evening, underscoring just how meaningful the gathering was for patients, families and providers alike.

The program featured insights from the expert surgical team at Children’s National, who discussed the latest treatment options, innovative techniques and supportive resources available. The care team’s message was clear: no family walks this path alone, and cutting-edge solutions are being developed and delivered every day at the hospital.

More than education

This is the second year for this event that began as an annual educational program but has quickly blossomed into something much greater — a celebration of resilience and the power of community. Families gather in an atmosphere of warmth and understanding, sharing stories, struggles and victories. For many, this event is the first opportunity for them to meet others who truly understand their journey with pediatric achalasia. The connections create an invaluable sense of unity and belonging.

The parent and patient panel, where families courageously share their experiences — the uncertainty of diagnosis, the daily challenges of living with achalasia and the transformative impact of surgical care, was especially impactful according to attendees.

The enthusiasm of the attendees highlights the importance of creating spaces where families can connect, learn and inspire one another.

Why it matters

Achalasia is a rare condition in adults (1/100,000) and even less common in children, occurring in only 0.1 per 100,000 patients with an estimated prevalence of 10 per 100,000. The rarity of achalasia in children compared with adults makes collecting enough statistically significant evidence about how best to treat them difficult, more so than for other more common pediatric surgical conditions.

The growth program at Children’s National tackles big questions for children with inflammatory bowel disease

October 8, 2025

Children’s National Hospital’s Growth Program is uncovering sex-specific differences in pediatric Crohn’s disease to guide more personalized treatments and help children with inflammatory bowel disease achieve healthy growth and development.

For kids with Crohn’s disease, growth isn’t just about inches on a chart. It’s a powerful signal of overall disease activity and disease status and how well treatment works. Children with an inflammatory bowel disease (IBD), like Crohn’s or ulcerative colitis, face challenges that go beyond flare-ups or fatigue. When growth slows, it can be a warning sign that inflammation is still active or that treatment needs to change. “Growth is not just about height,” says Neera Gupta, MD, MAS, Director of the Growth Program for Inflammatory Bowel Diseases at Children’s National. “It’s a powerful marker for how well the underlying disease is controlled.”

Dr. Gupta is leading a groundbreaking research project known as the growth study. The work is uncovering why the frequency of growth impairment in boys and girls with Crohn’s disease is different, pointing to sex-specific molecular pathways that may affect how well children respond to specific therapies for Crohn’s disease. Mapping these sex-specific differences could pave the way for sex-specific risk-based personalized treatment approaches, something IBD care has never done before.

Big picture

The implications are exciting. “In 10 years, we’ll be saying, ‘Of course we should be managing boys and girls differently’ for many different chronic inflammatory diseases. ‘Why would we be treating them the same?’” says Dr. Gupta. Her vision marks a major shift from one-size-fits-all treatments to sex-specific therapies designed around a child’s unique biology.

The growth program itself brings families face-to-face with experts who understand both the science and the lived experience of IBD. Each visit includes an in-depth review of growth, nutrition and treatment, along with the chance to participate in studies like the growth study. It’s where research and care meet, offering children and families hope and practical solutions at the same time.

What’s Next

Recently, this work was recognized by the Crohn’s & Colitis Foundation in its “Under the Microscope” bulletin, a national publication that highlights cutting-edge research in the field. This recognition underscores Children’s National’s role as a leader in pediatric IBD care and sends a clear message to families: always ask about your child’s growth status at every visit.

By proposing sex-specific therapeutic approaches using data collected in the growth study, Children’s National is shaping a new era of pediatric IBD care. Growth is more than a number, and researchers at Children’s National are at the forefront of helping children with IBD reach their full growth and developmental potential.

Children’s National Hospital once again ranked among the nation’s best by U.S. News & World Report

October 7, 2025

Children’s National Hospital in Washington, D.C., was ranked as a top hospital in the nation by the U.S. News & World Report 2025-26 Best Children’s Hospitals annual rankings. This marks the ninth straight year Children’s National has made the Honor Roll list. The Honor Roll is a distinction awarded to only 10 children’s hospitals nationwide.

For the fifteenth straight year, Children’s National ranked in 10 specialty services and is the highest U.S. News ranked children’s hospital in Washington, D.C., Maryland and Virginia. Last year, U.S. News introduced pediatric & adolescent behavioral health as a service line in its rankings. While there are no ordinal rankings for behavioral health, the Children’s National program was named one of the top 50 programs in the country for the second year in a row.

“To be named among the nation’s top children’s hospitals for nine years in a row is a reflection of the extraordinary expertise, innovation and heart that our teams bring to every child and family we serve,” said Michelle Riley-Brown, MHA, FACHE, president and chief executive officer of Children’s National. “Our leadership in specialties like neurology, cancer, and diabetes and endocrinology underscores the national impact of our work, and we remain focused on setting new standards in pediatric care.”

The annual rankings are the most comprehensive source of quality-related information on U.S. pediatric hospitals and recognizes the nation’s top 50 pediatric hospitals based on a scoring system developed by U.S. News.

“Being a top-ranked pediatric hospital means more than just excelling in a single specialty — it means being a pillar of outstanding care for your entire region,” said Ben Harder, chief of health analysis and managing editor at U.S. News. “Our rankings acknowledge these hospitals for their comprehensive excellence, helping families find the very best care conveniently located within their state and community.”

The bulk of the score for each specialty service is based on quality and outcomes data. The process includes a survey of relevant specialists across the country, who are asked to list hospitals they believe provide the best care for patients with the most complex conditions.

The Children’s National specialty services that U.S. News ranked in the top 10 nationally are:

Neurology and Neurosurgery (No. 4), led by Division Chiefs William D. Gaillard, MD, and Robert F. Keating, MD
Diabetes and Endocrinology (No. 6), led by Division Chief Andrew Dauber, MD, MMSc
Cancer (No. 8), led by Division Chief Eugene Hwang, MD
Nephrology (No. 10), led by Division Chief Marva Moxey-Mims, MD
Orthopedics (No. 10), led by Division Chief Matthew Oetgen, MD, MBA

The other six specialties ranked among the top 50 are Behavioral Health, Cardiology and Heart Surgery, Gastroenterology and GI Surgery, Neonatology, Pulmonology and Lung Surgery, and Urology.

Dr. Levitt and Colorectal Team Overseas with the local surgeons from Cote D’Ivoire

Advancing global surgical care: Children’s National colorectal team at PAPSA 2025

July 10, 2025

Dr. Levitt mentoring surgeons from 14 African countries on a complex colorectal operation.

At the 14th Congress of the Pan-African Pediatric Surgery Association (PAPSA) in Abidjan, Côte d’Ivoire, Marc Levitt, MD, chief of Colorectal and Pelvic Reconstruction at Children’s National Hospital, was invited to deliver one of the primary courses, a rare honor reserved for leaders in the field. Held only once every 2 years, the PAPSA meeting draws more than 300 pediatric surgeons from across Africa, making it the continent’s most significant gathering dedicated to pediatric surgery. Dr. Levitt’s role in the event highlights both his global expertise and the ongoing commitment of Children’s National to advancing pediatric surgical care and education in low- and middle-income countries.

Just prior to the congress, Dr. Levitt and his organization, Colorectal Team Overseas, led an international team of surgeons in partnership with the local surgical team to care for 17 children from Côte d’Ivoire and several neighboring countries with complex colorectal conditions. These conditions included anorectal malformations, cloaca and Hirschsprung’s disease, which can severely affect quality of life if untreated. Founded by Dr. Levitt, Colorectal Team Overseas advances global pediatric surgical care through education and hands-on training, extending the expertise of Children’s National to children around the world. Joining him on the mission were colorectal surgeon Andrea Badillo, MD, and surgical technician Guy Ozigre, both from Children’s National. The course also welcomed pediatric surgeons from 14 African nations, promoting collaboration and skill-building.

A busy clinic in preparation of the operating room days.

Among the many teaching highlights was the first-ever perineal body preserving posterior sagittal anorectoplasty performed in Western Africa, a technique pioneered at Children’s National. “These are life-changing procedures, and it was a privilege to perform them with such dedicated teams, who were so eager to learn,” said Dr. Levitt. “The hospital’s facilities were excellent, and the professionalism and warmth of the Ivorian teams made this an unforgettable experience.”

The workshops and surgeries, hosted at the Mother-Child Hospital Dominique Ouattara in Bingerville, reflected PAPSA’s core mission: to treat, train and transmit. With pediatric surgical needs continuing to outpace available expertise in many African countries, initiatives like this one are vital to training local specialists and developing sustainable care, according to the host and chief of pediatric surgery, Rouma Bankole, MD.

“Sharing knowledge and training the next generation of pediatric surgeons is the key to improving outcomes globally,” said Dr. Levitt.

Dr. Levitt and Colorectal Team Overseas with the local surgeons from Cote D’Ivoire

Colorectal care across borders: expanding access through global collaboration

May 16, 2025

Members of the Division of Colorectal & Pelvic Reconstruction at Children’s National Hospital recently traveled to Sao Paulo, Brazil, with the goal of advancing surgical care for children with complex colorectal conditions. Led by Division Chief Marc Levitt, MD, the team collaborated closely with surgeons and nurses at Hospital Municipal Infantil Menino Jesus, performing multiple intricate procedures each day and giving a course to 120+ surgeons from all over Brazil and several surrounding countries. The operations performed and the education that was provided not only gave life-changing care to children in need but also served as critical teaching opportunities, equipping local surgical teams with the skills and knowledge to deliver specialized care in their own communities. In this way, the team from Children’s National is helping countless children they will never meet, as their new partners in Brazil now have the skills to care for them

This mission was organized through Colorectal Team Overseas, an organization founded and led by Dr. Levitt to advance global pediatric surgical care through education and hands-on training. Colorectal Team Overseas gives Dr. Levitt the opportunity to extend the world-class care delivered at Children’s National to children around the world.

“Every child deserves a chance at a healthy, dignified life, no matter where they are born,” says Dr. Levitt. “On these missions, doctors, nurses and volunteers from the colorectal program at Children’s National and colleagues from around the world work hand-in-hand with medical teams in Brazil — not only to provide surgical care, but to teach, learn and build a foundation for a lasting impact. We are not just performing surgeries; we are restoring futures, together.”

REI Week 2025 empowers the future in pediatric research and innovation

April 22, 2025

Children’s National Hospital hosted its fifteenth annual Research, Education and Innovation Week from March 31–April 4, 2025, bringing together clinicians, scientists, educators and innovators from across the institution to celebrate discovery and collaboration. This year’s theme, “Empowering the Future in Pediatric Research and Innovation with Equity, Technology and a Global Reach,” served as a call to action for advancing science that improves child health both locally and around the world.

Each day of the week-long event featured thought-provoking lectures — now available to watch — dynamic panel discussions, interactive workshops and vibrant poster sessions, all highlighting the diverse and interdisciplinary work taking place across Children’s National.

Centering the patient and the planet

REI Week began on Monday with a powerful keynote lecture from Lynn R. Goldman, MD, MS, MPH, Michael and Lori Milken dean of the Milken Institute School of Public Health at the George Washington University. In her talk, “Children: Uniquely vulnerable to climate-related threats,” Dr. Goldman underscored the urgent need to protect children from the environmental hazards of a changing climate and to integrate climate science into pediatric care and advocacy.

At mid-morning, Mary-Anne “Annie” Hartley, MD, PhD, MPH, director of the LiGHT Laboratory at École Polytechnique Fédérale de Lausanne, introduced the “MOOVE” platform — Massive Open Online Validation and Evaluation of clinical LLMs. Her talk demonstrated how artificial intelligence, when rigorously validated, has the potential to transform clinical decision-making and global health equity.

Monday’s final keynote, “Zinc and childhood diarrhea,” was presented by Christopher Duggan, MD, MPH, director of the Division of Nutrition at Harvard Medical School. Dr. Duggan highlighted the global health impact of zinc supplementation in reducing childhood mortality — a reminder that simple, evidence-based interventions can save millions of lives.

In that first day, the first poster session of the week showcased projects in adolescent medicine, global health, infectious diseases, oncology and more. The session reflected the full breadth of research taking place across Children’s National.

Ambroise Wonkam, MD, PhD, professor of genetic medicine at Johns Hopkins University, then delivered Tuesday’s Global Health Keynote Lecture, “Harnessing our common African genomes to improve health and equity globally.” His work affirmed that inclusive genomics is key to building a healthier world.

Later, the Global Health Initiative event and GCAF Faculty Seminar encouraged attendees to pursue collaborative opportunities at home and abroad, reflecting the growing global footprint of Children’s National research programs.

Transforming education and care delivery

On Wednesday, Larrie Greenberg, MD, professor emeritus of pediatrics, kicked off the day with a Grand Rounds keynote on educational transformation: “Shouldn’t teachers be more collaborative with their learners?” He followed with a CAPE workshop exploring the effectiveness of case-based learning.

The Nursing Sponsored Keynote Lecture by Vincent Guilamo-Ramos, PhD, MPH, LCSW, ANP-BC, PMHNP-BC, FAAN, explored “Redesigning the U.S. broken health system.” He offered an urgent and inspiring call to reimagine pediatric care by addressing social determinants of health.

In the Jill Joseph Grand Rounds Lecture, Deena J. Chisolm, PhD, director of the Center for Child Health Equity at Nationwide Children’s Hospital, challenged attendees to move beyond dialogue into action in her talk, “Health equity: A scream to a whisper?,” reminding researchers and clinicians that advocacy and equity must be foundational to care.

The day continued with a poster session spotlighting medical education, neonatology, urology and neuroscience, among other fields.

Posters and pathways to progress

Throughout the week, poster sessions highlighted cutting-edge work across dozens of pediatric disciplines. These sessions gave attendees the opportunity to engage directly with investigators and reflect on the shared mission of discovery across multiple disciplines, including:

Neuroscience and Neuroprotection – Novel approaches to brain injury treatment and neurodevelopmental disorders.
Genetics and Precision Medicine – Advances in understanding genetic predisposition and innovative therapies.
Health Disparities and Global Health – Strategies to bridge gaps in pediatric healthcare access worldwide.
Innovative Technology in Pediatrics – Breakthroughs in AI, bioinformatics and medical device development.

Honoring excellence across Children’s National

The REI Week 2025 Awards Ceremony celebrated outstanding contributions in research, mentorship, education and innovation. The winners in each category were:

POSTER SESSION AWARDS

Basic & Translational Research

Faculty: Benjamin Liu, PhD

“Genetic Conservation and Diversity of SARS-CoV-2 Envelope Gene Across Variants of Concern”

Faculty: Steve Hui, PhD
“Brain Metabolites in Neonates of Mothers with COVID-19 Infection During Pregnancy”

Faculty: Raj Shekhar, PhD
“StrepApp: Deep Learning-Based Identification of Group A Streptococcal (GAS) Pharyngitis”

Post docs/Fellows/Residents: Dae-young Kim, PhD
“mhGPT: A Lightweight Domain-Specific Language Model for Mental Health Analysis”

Post docs/Fellows/Residents: Leandros Boukas, MD, PhD
“De Novo Variant Identification From Duo Long-Read Sequencing: Improving Equitable Variant Interpretation for Diverse Family Structures”

Staff: Naseem Maghzian
“Adoptive T Lymphocyte Administration for Chronic Norovirus Treatment in Immunocompromised Hosts (ATLANTIC)”

Graduate Students: Abigail Haffey
“Synergistic Integration of TCR and CAR T Cell Platforms for Enhanced Adoptive Immunotherapy in Brain Tumors”

High School/Undergraduate Students: Medha Pappula
“An ADHD Diagnostic Interface Based on EEG Spectrograms and Deep Learning Techniques”

Clinical Research

Faculty: Folasade Ogunlesi, MD
“Poor Air Quality in Sub-Saharan Africa is Associated with Increase Health Care Utilization for Pain in Sickle Cell Disease Patients”

Faculty: Ayman Saleh, MD
“Growth Parameters and Treatment Approaches in Pediatric ADHD: Examining Differences Across Race”

Post docs/Fellows/Residents: Nicholas Dimenstein, MD, MPH
“Pre-Exposure Prophylaxis (PrEP) Eligibility in the Pediatric Emergency Department”

Staff: Tayla Smith, MPH
“The Public Health Impact of State-Level Abortion and Firearm Laws on Health Outcomes”

Graduate Students: Natalie Ewing
“Patterns of Bacteriuria and Antimicrobial Resistance in Patients Presenting for Primary Cloacal Repair: Is Assisted Bladder Emptying Associated with Bacteriuria?”

Graduate Students: Manuela Iglesias, MS
“Exploring the Relationship Between Child Opportunity Index and Bayley-III Scores in Young Children”

High School/Undergraduate Students: Nicholas Lohman
“Preliminary Findings: The Efficacy, Feasibility and Acceptability of Group Videoconference Cognitive Behavioral Therapy with Exposure and Response Prevention for Treating Obsessive-Compulsive Disorder Among Children and Young People”

Community-Based Research

Faculty: Sharon Shih, PhD
“Assessing Pediatric Behavioral Health Access in DC using Secret Shopper Methodology”

Post docs/Fellows/Residents: Georgios Sanidas, MD
“Arrested Neuronal Maturation and Development in the Cerebellum of Preterm Infants”

Staff: Sanam Parwani

“Intersectionality of Gender and Sexuality Diversity in Autistic and Non-Autistic Individuals”

Graduate Student: Margaret Dearey
“Assessing the Burden of Period Poverty for Youth and Adolescents in Washington, DC: A Pilot Study”

Quality and Performance Improvement

Faculty: Nichole L. McCollum, MD
“A Quality Improvement Study to Increase Nurse Initiated Care from Triage and Improve Timeliness to Care”

Post docs/Fellows/Residents: Hannah Rodriguez, MD
“Reducing Unnecessary Antibiotic Use in a Level IV NICU”

Staff: Amber K. Shojaie, OTD, OTR/L
“Implementing Dynamic Axilla Splints in a Large Burn Patient”

MENTORSHIP AWARDS

Basic Science Research

Conrad Russell Y. Cruz, MD, PhD

Clinical Research

Rana Hamdy, MD, MPH, MSCE

Bench to Bedside Research

Ioannis Koutroulis, MD, PhD, MBA

ELDA ARCE TEACHING SCHOLAR AWARD

Priti D. Bhansali, MD, MEd

Heather Ann Walsh, PhD, RN

SUZANNE FEETHAM NURSING RESEARCH SUPPORT AWARD

Eileen P. Engh, PhD RN
“Rare Disease Organization Lifecycle” Role in Helping Parents with Everyday Life Information Seeking and Connection (RDO-HELIX)

EXPLORATIONS IN GLOBAL HEALTH PILOT AWARDS

Launchpad Awards

Mi Ran Shin, MD, MPH
“Establishing Interdisciplinary Rehabilitation for Birth and Burn Injuries in Ethiopia”

Susan Harvey, MSN, CPNP-AC
“Implementation of Sickle Cell Pilot Program in Ndhiwa Sub County, Kenya”

Meleah Boyle, PhD, MPH
“Understanding and Addressing Environmental Sustainability to Protect the Health of the Children’s National and Global Communities”

Eiman Abdulrahman, MD
“Research Capacity Building to Improve Pediatric Emergency and Critical Care in Ethiopia”

Pilot Awards

Alexander Andrews, MD
“EEG as a Diagnostic and Prognostic Marker in Severe Pediatric Malaria, Blantyre Malawi”

Daniel Donoho, MD & Timothy Singer, MD
“Feasibility Study of a Novel Artificial Intelligence-Based Educational Platform to Improve Neurosurgical Operative Skills in Tanzania”

Hasan Syed, MD
“Bridging the Gap an Educational Needs Assessment for Pediatric Neurosurgery Training in Pakistan”

Sofia Perazzo, MD & Lamia Soghier, MD, MEd, MBA
“QI Mentorship to Improve Pediatric Screening and Follow-up in Rural Argentina”

Benjamin Liu, PhD
“AI-Empowered Real-Time Sequencing Assay for Rapid Detection of Schistosomiasis in Senegal”

Rae Mittal, MD
“Assessment and Enhancement of Proficiency in Emergency Child Neurology Topics for Post-Graduate Emergency Medicine Trainees in India”

Innovation Day ignites bold thinking

Thursday, REI Week shifted to the Children’s National Research & Innovation Campus for Innovation Day, a celebration of how bold ideas and collaborative culture can accelerate progress in pediatric medicine.

Brandy Salmon, PhD, associate vice president of Innovation and Partnerships at Virginia Tech, opened the day with “The Alchemy of Innovation,” focusing on how institutions can build a culture that fuels transformative partnerships.

A multidisciplinary panel discussion moderated by Nathan Kuppermann, MD, MPH, and Catherine Bollard, MBChB, MD, featured Nehal Mehta, MD, Julia Finkel, MD, Kevin Cleary, PhD, Ioannis Koutroulis, MD, PhD, MBA, Francesca Joseph, MD and Patrick Hanley, PhD, who shared how innovation can be advanced and promoted, especially as a core institutional priority.

A shared vision for the future

REI Week 2025 reaffirmed the values that define Children’s National: a commitment to excellence, collaboration and equity in pediatric research and care. As discoveries continue to emerge from our hospital and our research campuses, the connections built and ideas sparked during this week will help shape the future of pediatric health — locally and globally.

By elevating voices from the bedside to the bench, with the support of the executive sponsors Nathan Kuppermann, MD, MBChB, Catherine Bollard, MBChB, MD, Kerstin Hildebrandt, MSHS, Linda Talley, MS, RN, NE-BC and David Wessel, MD, REI Week demonstrated that we must embrace the community in all aspects of our work. Because we know that there are answers we can only get from the patients that we serve—and we need to be their voice.

Research, Education & Innovation Week will be back next year on April 13-17, 2026.

Posters at the REI Week 2025 Monday, March 31 poster session.
Panelists discuss innovation during REI Week 2025.
Global Health Initiative community engagement event during REI Week 2025.
Chris Rees presents his REI Week 2025 lecture.
Nathan Kuppermann listens to a presenter during the REI Week 2025 Tuesday, April 1, poster session.
Michelle Riley-Brown, Nathan Kuppermann, Catherine Bollard and Naomi Luban on stage during the REI Week 2025 awards ceremony.
Brandy Salmon presents on innovation programs at Virginia Tech during the REI Week 2025 Innovation Day.
Catherine Bollard listens to a presenter during the REI Week 2025 Monday, March 21 poster session.
Ambroise Wonkman poses for a picture with Children’s National staff.
Tanzeem Choudhury presenting during REI Week 2025.

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Study highlights need for improved screening in anorectal malformation patients

March 12, 2025

A recent study from the Division of Colorectal and Pelvic Reconstruction at Children’s National Hospital, led by Chief Marc Levitt, MD, explores the prevalence of additional abnormalities in children born with anorectal malformations (ARM). While many of these abnormalities co-occur, including vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula or esophageal atresia, renal defects and limb defects, known as the VACTERL association, the study reveals that some critical anomalies, particularly spinal cord and gynecologic malformations, are often missed, an oversight that can significantly affect patient outcomes.

What it means

This multi-institutional retrospective study aimed to assess the effectiveness of current diagnostic criteria for VACTERL screening in ARM patients and to identify anomalies that are at risk of being overlooked. The researchers utilized data from the Pediatric Health Information Systems database, which includes over 100 children’s hospitals, to analyze a wide range of associated abnormalities in ARM across the United States.

The findings highlight that the most common anomalies in ARM patients include cardiac, vertebral/spinal, renal and gynecologic (in females). While many of these anomalies are diagnosed at birth, the study suggests that some are identified only later in a patient’s care, pointing to a gap in early screening, particularly for spinal cord and gynecologic issues.

Based on the study’s results, the authors propose an expansion of the VACTERL acronym to VACTE(G)RLS to stress the importance of gynecologic (G) and spinal cord anomalies (S) in ARM patients.

Based on the study’s results, the authors propose an expansion of the VACTERL acronym to VACTE(G)RLS to stress the importance of gynecologic (G) and spinal cord anomalies (S) in ARM patients. This expanded acronym would help ensure that both surgical and non-surgical providers are aware of these often-missed malformations, improving early diagnosis and intervention.

Why it matters

Although other studies have examined the prevalence of VACTERL anomalies in ARM patients, this is the first to compare diagnosis rates at birth with diagnoses made later during subsequent hospital admissions. Timely identification of these associated malformations is crucial for early intervention in females, as untreated gynecologic anomalies can lead to reproductive issues later in life and for patients with spinal conditions that require intervention.

The proposed change to the standard usage VACTERL acronym underscores the significance and frequency of these malformations happening in combination, potentially leading to improved screening protocols and, ultimately, better patient outcomes. By emphasizing the importance of comprehensive screening at birth, the study advocates for a more thorough approach to diagnosing ARM-associated anomalies, which can significantly enhance long-term care for these patients.

Authors from Children’s National include – Thomas Xu, MD, Andrea Badillo, MD, Briony Varda, MD, MPH, Christina Feng, MD, and Marc Levitt, MD.

You can read the full study, VACTERL screening in newborns with anorectal malformations – an opportunity to optimize screening practices, add gynecologic and spinal conditions, and utilize a new acronym: VACTE(G)RLS, in the Journal of Pediatric Surgery.

Patient-reported outcomes for children with anorectal malformation

February 25, 2025

Before this study, little has been documented about how anorectal malformation type, sacral ratio, age and bowel regimen affect continence and quality of life.

A large, multi-institutional study including patient-reported outcomes for children who have anorectal malformations found that the type of malformation and whether a child is clean/continent and not soiling can have a significant impact on the assessment of a patient’s quality-of-life. The study also highlights that patients and their families seem to benefit from access to a specialized center offering multi-disciplinary care in a single location.

What it means

The study is one of the first to collect input from patients and their families at two multi-disciplinary centers for colorectal care. The authors, including Marc Levitt, MD, chief of Colorectal and Pelvic Reconstruction at Children’s National Hospital, who collaborated with colleagues at Nationwide Children’s Hospital in Columbus and Royal Children’s Hospital in Melbourne Australia, sought to understand the impact of the anorectal malformation type and the development of the sacrum bone on continence outcomes in children. Additionally, the team aimed to compare continence outcomes by age group and determine the quality of life with different bowel regimens, including medications like laxatives or the use of enemas.

The researchers found that continence in patients taking laxatives to manage their bowels varied depending on the type of malformation, but that sacral ratio or a measure of the growth of a key pelvic bone correlating with pelvic floor development, did not seem to play a role in continence.

Additionally, patients (and patient families) had similar perceptions of their overall quality of life, as long as the child was clean/continent. Quality-of-life scores were lower, however, if a child was managed using enemas but continued to experience soiling/incontinence. This vital component was a measure of patient reported outcomes, or how the patient perceives their care is going.

Why it matters

Before this study, little has been documented about how anorectal malformation type, sacral ratio, age and bowel regimen affect continence and quality of life. For the first time, these reports are coming from the patient and family point of view. In their conclusion, the authors note that the study’s findings provide important discussion points for counseling patients on long term management strategies for children with anorectal malformations. The findings also identify new areas for research driven by what patients and their families report are most important.

Read the full study, Patient-reported outcomes of Children with an Anorectal Malformation in the Annals of Surgery.

Children’s National to host annual Pediatric Inflammatory Bowel Disease Research Days Meeting

February 11, 2025

The division of Gastroenterology, Hepatology and Nutrition at Children’s National Hospital is proud to host the Pediatric Inflammatory Bowel Disease Research Days (PIBDRD) Meeting from April 10-11, 2025.

This two-day event will include discussing recent advances in pediatric Inflammatory Bowel Disease (IBD) research, identifying gaps in knowledge in pediatric IBD and identifying target areas for future pediatric IBD research. Presentation themes will include sex differences in presentation, disease course and response to treatment; growth; nutrition; and other pediatric chronic inflammatory conditions.

This two-day event will offer CME credits and features a robust lineup of experts in the field of Inflammatory Bowel Disease and other chronic inflammatory conditions.

To review the this year’s agenda and register to attend, visit ChildrensNational.org/PIBDRD.

A breakthrough quality of life survey for kids with celiac disease

January 22, 2025

A research team led by Dr. Shayna Coburn, from Children’s National Hospital, developed a first-of-its-kind celiac disease-specific pediatric Quality of Life measure survey.

Celiac disease is a genetic autoimmune disorder that disrupts nutrient absorption and results in a permanent intolerance to gluten. Assessing quality of life (QOL) is a vital component in the screening and management of this chronic condition. In a study published in the American Journal of Gastroenterology, researchers from Children’s National Hospital developed a first of its kind celiac disease-specific pediatric QOL measure (CDLIFE) survey. Shayna Coburn, PhD, psychosocial health director of the Celiac Disease Program and lead author of the study, shared how Children’s National is leading the way with this work.

What’s been the hold-up in the field?

Several surveys have been developed to assess quality of life in individuals with celiac disease; however, they present significant limitations when applied to pediatric populations. Some instruments were developed in other countries, where differing food environments and support resources for individuals with celiac disease affect their applicability. Additionally, existing tools often target adults, while pediatric-focused surveys are restricted to children aged eight years and older. This constraint is increasingly problematic as the age of celiac disease diagnosis continues to decrease. Notably, in our celiac disease clinic, approximately half of our patients are under the age of eight, highlighting the critical need for a QOL assessment tool tailored to this younger demographic.

How does this work move the field forward?

This work represents a significant advancement in the field by introducing the CDLIFE survey, a concise and user-friendly QOL survey designed specifically for individuals with celiac disease aged two to 18. The tool includes both a youth self-report and a parent-proxy form, providing flexibility in capturing QOL data across developmental stages. Developed with direct input from families, the CDLIFE survey reflects experiences and challenges that are most relevant to patients and caregivers.

This survey demonstrates strong correlations with existing measures of QOL and celiac disease-specific experiences, ensuring its validity and reliability while adhering to FDA guidelines for patient reported outcome measures.

How will this work benefit patients?

The CDLIFE survey provides a valuable tool for patients and health care providers to assess how individuals are managing life with celiac disease, offering insights into areas where additional support may be needed. This survey empowers providers to deliver more personalized and targeted care and serves as a vital resource in research. It enables a deeper understanding of patient experiences and function by serving as a reliable patient-reported outcome measure in clinical trials.

How is Children’s National leading in this space?

The CDLIFE survey is the first pediatric QOL measure specifically designed to include young children, addressing a critical gap in current tools. Its development has generated significant enthusiasm within the pediatric celiac disease community, evidenced by numerous requests for the tool even prior to its formal publication. By leading this effort, Children’s National is part of a select group of institutions driving innovation and setting new standards for understanding and improving quality of life for youth with celiac disease.

Authors on the study from Children’s National include: Pamela Hinds, RN, PhD, FAAN, Randi Streisand, PhD, James Bost, PhD, Jack Vagadori, MS, and Paige Trojanowski, PhD.

Colorectal surgeons ensure recognition for surgical innovation of Dr. Asa Yancey

January 6, 2025

Dr. Asa Yancey’s pioneering operation went unrecognized for over half a century due to discriminatory publishing practices in academic medicine.

A group of international pediatric colorectal surgery leaders called for the renaming of a surgical procedure for Hirschsprung disease after finding evidence that an African American surgeon, Asa Yancey, M.D., had pioneered the procedure 12 years before its’ current namesake, Franco Soave, M.D. Dr. Yancey was not recognized previously due to discriminatory practices in academic medical publishing.

What it means

A literature review published in the Journal of Surgical Research conducted by the American Pediatric Surgical Association Hirschsprung disease interest group, including Marc Levitt, M.D., chief of Colorectal and Pelvic Reconstruction at Children’s National Hospital, identified that Dr. Yancey’s work describing pull-through of normal colon through a cuff of aganglionic colon as a treatment for Hirschsprung disease was published in 1952. The paper by Soave was published in 1962 and from that work, the “Soave” procedure bore his name.

The authors point out that Dr. Yancey’s pioneering operation went unrecognized for over half a century because of the discriminatory segregation in the publishing practices of academic medicine dating back to the 1950s.

Moving the field forward

Dr. Levitt and his colleagues in the interest group suggested active changes to give posthumous credit to Dr. Yancey, including renaming the procedure to the Yancey-Soave pull-through technique.

Together with Dr. Yancey’s family, including his children, three of whom are physicians, the interest group and other surgeons have started using the procedure’s new name in presentations, operative notes, articles and book chapters.

At the end of their literature review recommending the update, the authors wrote, “Posthumous acknowledgment of Yancey was long overdue but signifies improvements in the inclusion of underrepresented groups in academic medicine while simultaneously reminding physicians that there is still much work to be done.”

Read the article The Story of Dr. Asa G. Yancey and Surgical Innovation in the Face of Discrimination in the Journal of Surgical Research.

The Division of Colorectal & Pelvic Reconstruction team from Children’s National Hospital at the 2024 PLPLC Conference.

Pediatric colorectal experts gather: 2024 PCPLC Conference

December 27, 2024

The Division of Colorectal & Pelvic Reconstruction team from Children’s National Hospital at the 2024 PLPLC Conference.

Medical professionals from across the world gathered in Atlanta, Georgia, for the 2024 Pediatric Colorectal and Pelvic Reconstruction Conference. This esteemed course, hosted by the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC), provided comprehensive educational experiences to those caring for children with colorectal and pelvic disorders.

Children’s National Hospital staff showcased their expertise by leading in-depth discussions, presenting accepted abstracts and designing course programming across multiple specialty areas while highlighting the program’s focus on collaborative care. Led by Chief Marc Levitt, M.D., the division of Pediatric Colorectal and Pelvic Reconstruction is the first in the mid-Atlantic region to fully integrate surgery, urology, gynecology and gastroenterology into one cohesive program for children.

Presenters and topics from Children’s National included:

Course organizers:

Marc Levitt, M.D., Education Committee member, Surgical Conference planner
Briony Varda, M.D., M.P.H., Urology Committee chair, Cloaca Committee member, Documentation Committee member
Andrea Badillo, M.D., Documentation Committee member, Education Committee member
Julie Choueiki, M.S.N., R.N., Allied Health Care Professionals Conference (AHCP) co-chair

Dr. Marc Levitt leads a hands-on simulation lab using validated surgical models for treating Anorectal Malformations and Hirschsprung Disease.

Invited speakers and topics:

Marc Levitt, M.D., Cloaca Advanced; Anorectal Malformations/Hirschsprung Disease Hands-On Course; Hirschsprung disease and Constipation
Briony Varda, M.D., M.P.H., Genitourinary Complications & Creative Solutions: A Case Based Discussion of Patients with ARM; Cloaca Basics; Challenging Case Presentations in Colorectal Care
Katherine Worst, N.P., CPNP-AC, Functional Constipation, Motility, Bowel Management Basics; Bowel Management of the Colorectal Patient Including Psychosocial Care and Pelvic Floor Physical Therapy; Cloaca Review Session for Allied Health Care Professionals
Allison Mayhew, M.D., Genitourinary Complications & Creative Solutions: A Case Based Discussion of Patients with ARM; Advanced Cloaca; Cloaca Exstrophy, Gynecologic Evaluation and Follow Up
Andrea Badillo, M.D., Functional Constipation, Motility, Bowel Management Basics; Genitourinary Complications & Creative Solutions: A Case Based Discussion of Patients with ARM; Pediatric Colorectal Knowledge Competition at Course Conclusion
Christina Ho, M.D., Urological Care for the Colorectal Patient for Allied Health Care Professionals
Meghan Mesa, B.S.N., R.N., C.P.N., Performing Colorectal Clinic Skills for Allied Health Care Professionals
Justine Gagnon, B.S.N., R.N., Performing Colorectal Clinic Skills for Allied Health Care Professionals

Oral Plenary Scientific Session:

Thomas Xu, Hospital Volume and Region Associated with Variation in Vacterl Screening Among Newborns with Anorectal Malformation An Opportunity to Optimize Screening Practices
Kirsten Das, Gynecologic Anomalies in Patients with Anorectal Malformations and Associated Anomalies: A National Retrospective Cohort from 2016-2023
Eugénie Lehembre-Shiah, Cloacal Malformation And Mullerian Agenesis: Management Of The Gynecologic Reconstruction For This Rare Situation

Dr. Andrea Badillo on the panel for Functional Constipation, Motility, Bowel Management Basics.

Scientific Poster “Oral Quick Shot” Session (abstracts accepted):

Thomas Xu, Frequency of Vacte(G)Rls Associated Anomalies in Newborns with Anorectal Malformations Across Hospitals within the Pediatric Health Information Systems Database: Neonatal Diagnoses and Beyond; Malone Antegrade Continence Enema (Mace) – Reassessment of Complications with Advancements in Technique; Antegrade Continence Enemas for Patients with Spina Bifida to Treat Fecal Incontinence, a Comparison with Patients with Non-Neurogenic Causes
Jessica McAuliffe, N.P., F.N.P., Frequency and Severity of Diaper Dermatitis in Children Following Stoma Closure
Kirsten Das, Predicting The Need For Vaginal Augmentation In Patients Undergoing Cloacal Reconstruction

As a globally recognized expert in enhancing care of children with colorectal and pelvic reconstructive needs, Dr. Levitt, , along with Alejandra Vilanova-Sanchez, M.D., edited the textbook Pediatric Colorectal and Pelvic Reconstructive Surgery. As part of his commitment to advancing education about colorectal surgery, Dr. Levitt provided a copy of the textbook to every conference attendee.

Children’s National in the News: 2024

December 26, 2024

In 2024, Children’s National Hospital continued to make remarkable strides across diverse areas of pediatric medicine, from groundbreaking technological innovations to critical health advocacy. The following compilation showcases ten significant stories that demonstrate the breadth and depth of the hospital’s impact, as featured in major national news outlets including NBC Nightly News, CNN, The Washington Post, The New York Times, NPR, The Today Show, Healio, and POLITICO. Delve into our 2024 news highlights for more.

1. World’s smallest pacemaker gives new hope to babies with heart defects

Charles Berul, M.D., and a patient family talk about the pill-sized pacemaker that saved the life of Abby, an infant born with deadly heart defects. (NBC Nightly News)

2. ‘A $10 death trip’: Fentanyl is killing teens. Meet one fighting for his life

Sivabalaji Kaliamurthy, M.D., addiction psychiatrist and director of the Addictions Program, spoke to CNN about the impact of drug addiction on teen health and the lack of resources available to treat opioid use disorder. (CNN)

3. Health panel urges interventions for children and teens with high BMI

Susma Vaidya, M.D., M.P.H., associate medical director of the IDEAL Clinic, shared her concerns about childhood obesity treatment recommendations issued today by a leading panel of independent U.S. health experts. (The Washington Post)

4. An Rx for food? Doctor’s offices offer groceries to those in need

Shideh Majidi, M.D., M.S.C.S., and Emily Frymark, clinical dietitian, spoke about how the food pharmacy, created in partnership with the Capital Area Food Bank, benefits patients with diabetes and other chronic conditions. (The Washington Post)

5. First patient begins newly approved sickle cell gene therapy

Kendric Cromer, a 12-year-old boy being treated at Children’s National Hospital, became the first person in the world with sickle cell disease to begin a commercially approved gene therapy that may cure the condition. “This is a big effort,” says David Jacobsohn, M.D., ScM, M.B.A. (The New York Times)