Inflammatory Bowel Disease in Children

About Inflammatory Bowel Disease

Inflammatory bowel disease refers to two chronic (or recurring) conditions called “Crohn’s disease” and “ulcerative colitis,” which cause redness and swelling (inflammation) in parts of the intestinal tract. Like asthma, IBD symptoms in children occur in bouts — periodically flaring up for sometimes weeks or months.

 
What’s the Difference Between IBS and IBD?

Often confused with irritable bowel syndrome (IBS), IBD is a condition that can cause the intestines to narrow and restrict food from moving through the bowel. IBS is a functional disorder, which means the digestive system looks perfectly normal, but it doesn’t work exactly like it should. IBD and IBS have many similar symptoms, but IBS doesn’t cause blood in the stool (bowel movements or poop) like IBD can.

 
Crohn’s vs. Ulcerative Colitis in Children

Crohn’s disease and ulcerative colitis are both inflammatory bowel diseases that cause inflammation to different parts of the digestive system. Crohn’s can occur anywhere along the intestinal tract, but it’s commonly found in the last segment of the small intestine (ileum) and the large intestine (colon). Ulcerative colitis mostly affects the colon.

Crohn’s impacts the entire thickness of the intestine and can affect more than one section of the intestinal tract. In contrast, ulcerative colitis occurs only within the inner lining of the organ and is found only in one spot.

 
What Causes IBD in Children?

The exact cause of IBD in children is unknown. However, experts agree that the environment, genetics, and/or diet may have something to do with it. Scientists believe that an overactive immune system may trigger inflammation in response to an offending agent, like a virus or certain foods. Researchers are actively studying IBD to get to the bottom of possible causes, and hopefully help relieve IBD symptoms in children and adults.

Inflammatory Bowel Disease

What Is Inflammatory Bowel Disease?

Inflammatory bowel disease (IBD) is a condition that causes parts of the intestine (bowel) to get red and swollen. It's a chronic condition, which means it lasts a long time or constantly comes and goes.

There are two kinds of IBD: Crohn's disease and ulcerative colitis. These diseases have many things in common, but there are important differences:

  • Crohn's disease can affect any part of the gastrointestinal tract from mouth to anus (where poop comes out). The inflammation of Crohn's disease damages the entire bowel wall.
  • Ulcerative colitis happens only in the large intestine, or colon. It causes sores called ulcers that affect the inner lining of the colon.

What Are the Signs & Symptoms of Inflammatory Bowel Disease?

The most common symptoms of inflammatory bowel disease are belly pain and diarrhea. Other symptoms include:

  • blood in the toilet, on toilet paper, or in the stool (poop)
  • fever
  • low energy
  • weight loss

Inflammatory bowel disease can cause other problems, such as rashes, eye problems, joint pain and arthritis, and liver problems. Children with inflammatory bowel disease may not grow as well as other kids their age and puberty may happen later than normal.

What Causes Inflammatory Bowel Disease?

The exact cause of IBD is not clear. It is probably a combination of genetics, the immune system, and something in the environment that triggers inflammation in the gastrointestinal tract. Diet and stress may make symptoms worse, but probably don't cause inflammatory bowel disease.

Who Gets Inflammatory Bowel Disease?

IBD tends to run in families. But not everyone with IBD has a family history of the disease. Inflammatory bowel disease can happen at any age, but is usually diagnosed in teens and young adults.

How Is Inflammatory Bowel Disease Diagnosed?

Inflammatory bowel disease is diagnosed with a combination of blood tests, stool (poop) tests, and X-rays. Medical imaging tests, such as CT scans and MRI, might be done too.

The doctor will examine a stool sample for the presence of blood, and might look at the colon with an instrument called an endoscope, a long, thin tube attached to a TV monitor. In this procedure, called a colonoscopy, the tube is inserted through the anus to allow the doctor to see inflammation, bleeding, or ulcers on the wall of the colon. During the procedure, the doctor might do a biopsy, taking small samples that can be sent for further testing.

How Is Inflammatory Bowel Disease Treated?

IBD is treated with medicines, changes in diet, and sometimes surgery. The goal of treatment is to relieve symptoms, prevent other problems, and prevent future flare-ups.

A doctor may recommend:

  • anti-inflammatory drugs to decrease the inflammation
  • immunosuppressive agents to prevent the immune system from causing further inflammation
  • biologic agents to block proteins that cause inflammation
  • nutrition therapy to give the bowel a chance to heal

Because some medicines make it harder to fight infections, it's important that your child be tested for tuberculosis and have all recommended vaccines before starting treatment.

Surgery may be necessary if:

  • the bowel gets a hole
  • the bowel becomes blocked
  • bleeding can't be stopped
  • symptoms don't respond to treatment

What Else Should I Know About Inflammatory Bowel Disease?

Poor appetite, diarrhea, and poor digestion of nutrients can make it hard for people with inflammatory bowel disease to get the calories and nutrients the body needs. Children with IBD should eat a variety of foods, get plenty of fluids, and learn to avoid foods that make symptoms worse. Some children may need supplements, like calcium or vitamin D. Kids who are not growing well may need additional nutrition support.

Kids and teens with IBD can feel different and might not be able to do the things their friends can do, especially during flare-ups. Some struggle with a poor self-image, depression, or anxiety. They may not take their medicine or follow their diet. It's important to talk to your health care professional if you're concerned about your child's mood, behavior, or school performance.

Parents can help teens with IBD take on more responsibility for their health as they get older.

The Crohn's and Colitis Foundation is a good resource for more information and support.

Reviewed by: J. Fernando del Rosario, MD
Date reviewed: October 31, 2017