Kiyanna is a 9-year-old girl of mixed parentage (mother is Caucasian and father is African-American) who presented with abdominal pain, gas, headaches, and dizziness for the last 3 years of increasing severity and frequency, especially since March 2020. She is underweight. She had been seen by a pediatric gastroenterologist in the community who had tried her on antireflux medications, stool softeners, and an antispasmodic with no improvement. Her mother had also taken her to see an acupuncturist and nutritionist tosee if they could help with her symptoms.

Kiyanna was prescribed an elimination diet and was avoiding soy, wheat, and cow milk products with improvement in her symptoms.

Currently Kiyanna has daily, wide bowel movements that are easy to pass. Her mother retried cheese, which caused her to have abdominal pain and gas. Her family is vegetarian, but Kiyanna’s vegetable and fluid intake are poor. She had a negative celiac panel when she was eating gluten-containing foods. Past medical history is significant for her being born at 31 weeks gestational age and receiving nasogastric tube feeds for the first month of life. She also has a history of recurrent ear infections requiring antibiotics until she had ear tubes placed as a toddler.

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