Inflammatory Bowel Disease in Children

Gastrointestinal conditions, including inflammatory bowel disease (IBD) in children, are often difficult to diagnose because IBD symptoms in children, like abdominal pain and cramping, are common childhood complaints. That’s why it’s important for your child to be evaluated by board-certified pediatric gastroenterologists who have the expertise to accurately diagnose IBD in children, and develop a customized treatment plan.

At Nemours, we’re passionate about treating the whole child not just the condition. And we promise to do everything we can to make sure your child has more happy and healthy days with fewer IBD symptoms.

Learn More About Inflammatory Bowel Disease in Children

Inflammatory bowel disease refers to two chronic (or recurring) conditions called “Crohn’s disease” and “Ulcerative colitis,” which may result in inflammation (redness, swelling, or ulcerations) in parts of the intestinal tract.

Like asthma, Inflammatory bowel disease (IBD) in children is a chronic disease that can “flare up” from time to time. Although IBD requires lifelong care, it is a highly manageable condition. Our team can help your child reduce the amount of flare-ups for months or even years with medications, lifestyle changes, and in some cases, surgery.

IBD Symptoms in Children

Symptoms of inflammatory bowel disease (IBD) in children in children recur in bouts (flare-ups). They may include:
  • abdominal cramping
  • blood in the stool
  • diarrhea
  • constipation
  • weakness
  • fatigue
  • loss of appetite/weight loss
  • fever

Sometimes, Crohn’s disease and ulcerative colitis in children causes inflammation to other parts of the body, resulting in joint pain and/or skin rashes. Other times, IBD doesn’t cause symptoms, making the condition more difficult to readily diagnose.

Integrated Specialty Care for Pediatric Inflammatory Bowel Disease

At Nemours, we take a family-centered approach to caring for kids, which means our families play an active role in treatment decisions. Along with board-certified pediatric gastroenterologists, your medical team may include specialists in allergy and immunology, nutrition, genetics, pediatric surgery, psychology and psychiatry, and behavioral health — all working together to bring you the best in whole-child health care.

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Nemours/Alfred I. duPont Hospital for Children, Wilmington

1600 Rockland Road
Wilmington, DE 19803
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For Appointments: (302) 651-4200

Hours: 8 a.m. - 5 p.m.

U.S. News & World Report Best Children’s Hospitals: Gastroenterology & GI Surgery
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    Note: A parent or legal guardian must be with a child for a first visit.
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World-Class Inflammatory Bowel Disease Care from Nemours/Alfred I. duPont Hospital for Children

The pediatric gastroenterology (GI) team at Nemours/Alfred I. duPont Hospital for Children — ranked among the nations’ best by U.S. News & World Report — provides comprehensive, state-of-the art care for inflammatory bowel disease (IBD) in children.

Like asthma, IBD is a chronic disease that can “flare up” from time to time. Although IBD requires lifelong care, it’s a highly manageable condition. With the right treatment — which may include a combination of medicines, lifestyle changes and/or surgery — your child can be in “remission” (without flare-ups) for months or even years.

You can trust the medical team at duPont Hospital for Children to develop a comprehensive treatment plan so your child has less IBD flare-ups — and more happy days devoted to just being a kid.

Whole-Child Treatment and Care for IBD in Children

Our gastroenterologists work together with you, our families, and a team of medical specialists that may include geneticists, immunologists, developmental pediatricians, psychiatrists, nutritionists, and surgeons.

At duPont Hospital for Children you can expect the latest, most innovative IBD therapies, including:
  • complete diagnostic services: endoscopy, colonoscopy, and capsule endoscopy
  • full-range of radiology services: CT scans, MRI, and interventional radiology
  • advanced pediatric surgical services: including minimally invasive surgery
  • diet and nutritional services: diet plans, intravenous nutrition, and tube feeding
  • psychological care and treatment: emotional wellness for the entire family

Additional team members include professionals who help educate your family about IBD and treatments, find valuable resources (such as support groups or community programs), and cope with the stress of living with a chronic condition.

Your family is supported by:

We also offer many hospital services – including non-denominational spiritual care and integrative medical therapies – to heal the mind, body, and spirit.

Learn More About Support Services at Nemours/Alfred I. duPont Hospital for Children »

Diagnosing IBD in Children and Adolescents

IBD (collectively known as Crohn’s disease and ulcerative colitis) causes inflammation (redness, ulcerations, or swelling) in the intestinal tract. IBD symptoms in children are similar to many other pediatric GI conditions – which can sometimes cause a delay in diagnosis.

Left untreated, IBD can lead to complications like anemia (from gastrointestinal bleeding), malnutrition (due to poor food absorption), and stunted growth. In severe cases, IBD can cause serious damage to the intestinal tract and colon. Our specialists are experts at recognizing the symptoms and finding effective treatment plans.

Testing for IBD at duPont Hospital for Children

IBD may be the cause if your child is having recurring flare-ups (or bouts) of abdominal pain, blood in the stool, diarrhea, fever, vomiting, and/or weight loss.

Tests and procedures your doctor may order include:
  • Blood tests: to identify anemia, inflammation, or infection in the body.
  • Stool sample: to look for the presence of infection or blood in the stool (poop).
  • Barium study/X-rays: this test involves drinking a thick liquid (called barium) that shows up white on X-ray images, allowing us to view parts of the intestine that can’t be reached in a colonoscopy and endoscopy.
  • Magnetic resonance imaging (MRI): a special imaging test that allows us to see how the gastrointestinal tract is functioning without exposure to radiation.
  • Colonoscopy: a colonoscope (a long, thin tube with a small camera) is inserted into the rectum (bottom) to look for inflammation, ulcers, or bleeding in the colon. Most colonoscopies are done under general anesthesia, meaning your child is sound asleep during the test and will not feel any pain.
  • Endoscopy: an endoscope (a long, thin tube with a small camera) is inserted through the mouth to view the esophagus, stomach, and upper small intestine for signs of IBD. Similarly, most endoscopies are done while your child is under general anesthesia; however, sedation may also be used. Sedation makes your child sleepy and relaxed, without pain or anxiety.
  • Biopsy: tissue samples taken during a colonoscopy and/or an endoscopy for further analysis.
  • Wireless capsule endoscopy: sometimes called a "camera in a pill," this state-of-the-art procedure is a less invasive way to view parts of the small intestine that are difficult to see in other tests.
Relieving Your Child’s IBD Symptoms

Inflammatory bowel disease can be very painful for children and adolescents — physically and emotionally. Once you have an IBD diagnosis, our first goal is to alleviate and control your child’s symptoms as quickly as possible, usually through a short dose of powerful medications.

Managing IBD in Children

Once we relieve your child’s IBD symptoms, the next course of treatment focuses on managing the condition for fewer flare-ups.

Your physician may prescribe maintenance medications like:
  • anti-inflammatory medicines to reduce abdominal pain and diarrhea
  • corticosteroids to reduce pain, fever, and rectal bleeding
  • immune-suppressants to keep the immune system from attacking the body’s own tissue and to help control inflammation in the gastrointestinal tract

It may take time to get the right dosage and combination. But with careful attention and follow-up with our experienced Nemours medical team, we’ll get your child’s IBD symptoms under control.

The Role of Nutrition in Treating IBD in Children

Although changing your child’s diet won’t “fix” IBD, nutrition does play a role in treatment.

Your medical care team might suggest nutritional changes or supplements to help:
  • lessen some of the symptoms during an IBD flare-up
  • reduce the affects of certain medications
  • make sure your child is getting the vitamins and minerals needed for healthy growth and development

A nutritionist/dietitian will work with you to create a plan specific to your child’s needs.

IBD: When Surgery Is an Option

The first line of treatment for IBD in children is almost always medication and nutritional support. If non-surgical treatments don’t work or stop working, surgery can be option, but not necessarily a cure. The decision to have surgery depends on many things — particularly the type of IBD your child has. Your medical team and your family will make the decision together after weighing all of the potential outcomes, risks, and expectations.

If surgery is an option for your child, the procedures are different for Crohn’s disease and ulcerative colitis.

  • Crohn’s disease: A surgeon can remove a damaged section of intestine. It’s important to note that because inflammation can occur anywhere — at any time — along the intestinal tract, removing one section of the bowel doesn’t keep the disease from returning in another. For this reason, and because of other complications, we do whatever we can to successfully treat Crohn’s before recommending surgery.
  • Ulcerative colitis: A surgeon can remove the colon and the rectal lining and perform a procedure called an “ileoanal pull-through.” In this procedure, a pouch is made using the small bowel to collect stool in the pelvis that passes through the anus. About 20% of children with ulcerative colitis will need surgery at some point.

Our experienced pediatric surgeons at duPont Hospital for Children successfully perform hundreds of GI procedures each year — including state-of-the art minimally-invasive surgery — for children and teens throughout our region and beyond.

Learn More About Pediatric Surgery at Nemours/Alfred I. duPont Hospital for Children »

Ongoing Treatment and Care for Your Child’s IBD

IBD is a chronic disease that requires ongoing, lifelong follow-up and care.

At duPont Hospital for Children, we’ll continuously monitor your child for:
  • medication effectiveness
  • potential treatment side effects
  • healthy growth and development
  • physical and emotional well-being

And long before “aging out” of pediatric specialty care — and into the adult health system — we prepare teens with IBD to become responsible about managing their own care. Our Transition of Care program ensures young people understand their diagnosis, treatments, and other aspects involved with having a chronic medical condition, including how to talk to doctors, insurance providers, and more. That way, they can become healthy young adults with IBD.

Learn More About the Transition of Care Program at Nemours/Alfred I. duPont Hospital for Children »