In this interview, Annette Vannilam, MD, Pediatric Gastroenterologist, shares what drew her to Connecticut Children’s. Dr. Vannilam treats children of all ages who deal with gastrointestinal (GI) conditions ranging from uncomplicated to complex.
Pediatric gastroenterology in Westport, CT
1. What drew you to Connecticut Children's?
I loved that Connecticut Children’s has a mission to show compassion and a Culture of Kindness. I appreciated that they promoted that heavily when I onboarded, and throughout everything they do here. This is what makes Connecticut Children’s unique. I was also drawn to the location and wanted to be closer to family after having two kids in the last five years.
2. What inspired you to practice pediatric gastroenterology?
The field drew me in through my experiences as a learner. When I was in medical school, I originally thought I wanted to be a surgeon, but I ended up wanting to pursue something different. I realized I loved pediatrics and the type of cases I experienced in pediatric gastroenterology, and how it all varies between the age groups.
During one of my rotations, I did my first rectal section biopsy and it felt amazing to be able to do procedures to find a diagnosis. Ever since then, I have wanted to become a pediatric gastroenterologist.
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3. What's the best part about being a GI doctor for kids?
As a gastroenterologist, I feel fortunate to be able to help diagnose chronic conditions, sometimes after parents have been searching for answers for a long time. It is truly rewarding to see patients who have dealt with their symptoms for years finally have a way to manage their symptoms or feel completely better.
4. In a perfect world, what major or complex GI issue would you want to see a “cure” for in the next decade?
The most challenging diseases we see are Crohn’s disease or ulcerative colitis. While it’s more than possible to have a fulfilling life with both of those conditions, they can be severe and sometimes may require surgery. Currently, the only treatment is medications to try to get the disease into remission. A cure would be life changing for these patients.
5. GI is a relatively new field compared to other pediatric subspecialties. What has changed in the last decade or two?
The field has grown so much over the past 20 or so years. We have lots of new medications available for treatment of inflammatory bowel diseases (IBD). We have learned so much about the gut microbiome and its role in health, there are new medications for eosinophilic esophagitis (EoE) available and we have new technologies for evaluating intestinal dysmotility.
Connecticut Children’s has a Center for Pediatric Inflammatory Bowel Disease that is dedicated to improving the lives of kids with IBD, as well as a Center for Neurogastroenterology and Motility Disorders. Our IBD center is pioneering groundbreaking research funded by the National Institutes of Health (NIH).
6. Do you have any experiences that shaped you personally or professionally?
Personally, I have had a partial colectomy due to a volvulus (twist in my intestines causing ischemia or inadequate blood supply to the organ). After undergoing my own GI surgeries, I became greatly interested in gastrointestinal anatomy and loved understanding how changes in the development and function in the GI tract, and what causes them.
7. What recent developments or research have caught your attention and how do you foresee it having an effect on patient care?
Celiac disease has come a long way. Right now, researchers are trialing medications in clinical trials that could allow those with Celiac disease to actually eat gluten instead of going on a gluten-free diet for life. This would be a game changer for pizza lovers!
There have also been strides made in eosinophilic esophagitis (EoE), a chronic disease that causes the esophagus to swell. Dupixent is a new medication for the treatment of EoE that was just got FDA approval in January 2023 to be used in children as young 1 year of age.
Connecticut Children’s has great expertise in EoE and currently cares for over 500 children with EoE. While dietary therapy works in most, newer medications are showing great success in more complicated cases.
8. What gastrointestinal conditions do you see the most of in your patients?
Abdominal pain is definitely one of the most common complaints we see as gastroenterologists. Often we have to figure out if there is an underlying cause such as a gastric ulcer or constipation, or if the pain is due to disorders of the brain-gut interaction (DGBI). For the latter, we have a pediatric gastrointestinal psychologist, Dr. Bradley Jerson, PhD, who can help discuss the mind-gut relationship with patients and their families, and help patients develop coping skills to better manage their symptoms.
9. Let’s talk baby poop and spit-up. What’s normal—what’s not?
Baby poop can vary in color and consistency, and also change as infants start eating solids, or with different formulas. I tell new parents not to get worried unless it’s consistently black and tarry, or pale, or has bright red blood in it.
Spitting up is super common and can worsen between 4 and 6 months of age. I’ve met lots of happy spitters, my child included, who can spit up, up to 30 times a day. I worry about spitting up when babies are not gaining weight, have trouble breathing, have persistent irritability or are projectile vomiting.
10. What do you want patients and families to know about how Connecticut Children's cares for kids with gastrointestinal disorders?
We believe in evidence-based medicine. That means trying to use diagnostic and treatment approaches that are guided by science (evidence) but also common sense and compassion. We believe in partnering with families to reach outstanding outcomes and in always explaining why we do what we do.
11. Share a fun fact about yourself!
I am a Baptiste yoga teacher and was part of a non-profit yoga studio in Nashville, TN, where I taught yoga at elementary schools prior to the pandemic. I always love going to a hot yoga class.