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.
Crohn's disease 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.
Crohn's disease is an inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal tract from mouth to anus (where poop comes out). It's most commonly found at the end of the small intestine and the beginning of the large intestine. The inflammation of Crohn's disease damages the entire bowel wall.
What Are the Signs & Symptoms of Crohn's Disease?
The most common symptoms of Crohn's disease are belly pain and diarrhea. Other symptoms include:
blood in the toilet, on toilet paper, or in the stool (poop)
nausea or vomiting
skin tags, sores, or drainage around the anus
Because Crohn's disease damages the whole bowel wall, there can be scarring, narrowing of the bowel, and fistulas. A fistula is an abnormal connection between the bowel and skin, bladder, vagina, or other loops of bowel. A fistula may leak stool (poop), pus, or blood.
Crohn's disease can cause other problems, such as rashes, eye problems, joint pain and arthritis, and kidney stones and gallstones. Children with Crohn's disease may not grow as well as other kids their age and puberty may happen later than normal.
What Causes Crohn's Disease?
The exact cause of Crohn's disease 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 Crohn's disease.
Who Gets Crohn's Disease?
Crohn's disease tends to run in families. But not everyone with Crohn's disease has a family history of IBD. Crohn's disease can happen at any age, but is usually diagnosed in teens and young adults. People who smoke are more likely to get Crohn's disease.
How Is Crohn's Disease Diagnosed?
Crohn's 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 Crohn's Disease Treated?
Crohn's disease 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.
Your child's 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
Because some medicines make it harder to fight infections, it's important that your child be tested for tuberculosis and have all the recommended vaccines before starting treatment.
Surgery may be necessary if:
the bowel gets a hole
the bowel becomes blocked
a fistula forms
bleeding can't be stopped
symptoms don't respond to treatment
What Else Should I Know About Crohn's Disease?
Diarrhea, A lack of appetite, and poor digestion of nutrients can make it hard for people with Crohn's disease to get the calories and nutrients the body needs. Children with Crohn's disease should eat a variety of foods, get plenty of fluids, and learn to avoid foods that make symptoms worse. Some may need supplements, like calcium or vitamin D. Kids who are not growing well may need other nutrition support.
Kids and teens with Crohn's disease may feel different and 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.