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The Pediatric Gastroenterology Group at Broward Health
is Helping More Children Avoid Intestinal Transplants and Liver Disease
Broward Health’s pediatric gastroenterology team provides comprehensive care for a variety of digestive diseases and conditions affecting children, including inflammatory bowel disease (IBD), short bowel syndrome, reflux, constipation, milk protein allergy, liver conditions and more. The team cares for patients as young as premature infants and provides services throughout childhood and adolescence.
Pediatric gastroenterologist Natasha Mendez, M.D., specializes in treating children with IBD. “We take an individualized approach to caring for each patient,” Dr. Mendez said. “The pediatric gastroenterology team offers a rich variety of subspecialty care. The specialists’ skill sets complement one another and allow us to provide team-based treatment. Our areas of expertise include IBD, nutrition and intestinal rehabilitation.”
Offering sophisticated, complex care is a hallmark of the pediatric gastroenterology program. The intestinal rehabilitation service is one of many that reflects this approach
led by Debora Duro, M.D., M.S., program director of pediatric gastroenterology, hepatology and nutrition and medical director of the Florida Intestinal Rehabilitation Support and Treatment (FIRST) program for children.
Nonsurgical Care for Intestinal Failure
At Broward Health Medical Center, pediatric patients facing intestinal failure have access to the FIRST program, the brainchild of Dr. Duro.
The main cause of intestinal failure, short bowel syndrome (sometimes called short gut syndrome), can occur following surgery to treat necrotizing enterocolitis or gastroschisis. For patients with short bowel syndrome, customized nutritional care through the FIRST program can prevent the need for an intestinal transplant.
“Children who lose part of the intestine or their ability to absorb nutrients by the enteral route need supplementary or IV nutrition to grow and develop,” Dr. Duro said. “We can provide children with comprehensive nutritional support that aligns with their development in terms of growth optimizing bowel adaptation. Typically, later in life, most of these patients wean from this parenteral (IV) nutrition. The timing of weaning varies depending on each patient’s intestinal length and diagnosis.”
Working with a multidisciplinary team, Dr. Duro trains patients’ intestines in digestion and nutrient absorption, a process that includes developing a patient-specific nutrition customized plan. Thanks to the specialized care of the FIRST program, Dr. Duro has not had to refer any patients for intestinal transplantation or have patients suffering from TPN-induced liver disease.
Culinary Medicine for Better Outcomes
For many children with gastroenterological diseases, food plays a central role as either therapy or culprit. Increasingly, using food to treat these conditions — a field known as culinary medicine — is gaining prominence, including at Broward Health.
As chair of the nutrition committee for the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, Dr. Duro developed a culinary medicine curriculum for pediatric gastroenterology. In the clinic and at community events, she teaches children and parents to read nutrition labels, to teach parents healthy tips for cooking healthy meals and for choosing healthy foods.
“Our goal is to improve health outcomes through a healthier diet,” she said. “To do this, we provide nutritional education and culinary skills to help patients and their parents understand the benefits of certain foods, a high fiber diet and how to prepare meals with high nutritional value to elevate their diet quality.”
Expanding Expertise
Dyadin Esharif, M.D., FAAP, is one of three pediatric gastroenterologists at Broward Health. Coming from a private medical group where he covered calls at Broward Health Medical Center and Broward Health Coral Springs, Dr. Esharif joined the health system in March 2024.
“Broward Health offers many academic and teaching opportunities,” Dr. Esharif said. “Plus, we have all of the other pediatric subspecialties, which helps us practice high-quality pediatric gastroenterology and provide comprehensive care.”
Dr. Esharif has a particular interest in inflammatory bowel disease (IBD) and hopes to help build a pediatric IBD program in partnership with colleagues in pediatric gastroenterology and pediatric hematology. He performs several interventional procedures, including esophageal dilation for children with swallowing problems.
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