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.

Nemours Children's Hospital, Orlando


13535 Nemours Parkway
Orlando, FL 32827
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For Appointments: (407) 650-7715

 
What to Bring
  • photo ID
  • medical and pharmacy insurance cards
  • preferred pharmacy name and phone number
  • names and dosage of all medications, including over-the-counter medication, your child is currently taking
  • guardianship and custody papers, if a legal guardian rather than a parent accompanies your child
 
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Resources for Patients & Families

Pediatric gastroenterologists at Nemours Children’s Hospital expertly diagnose and treat inflammatory bowel disease (IBD) in children. Our team leads a comprehensive Inflammatory Bowel Disease Program that provides expert diagnosis, treatment and symptom management for children of all ages with IBD.

In addition to designated clinic days and education programs, our hospital offers advanced diagnostic technologies, including magnetic resonance enterography (MRE), and expert multidisciplinary care from surgeons, nutritionists and psychologists trained in the physical and emotional aspects of IBD.

Like asthma, IBD is a chronic disease that can "flare up" in children 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.

For your child, this means more happy days devoted to just being a kid.

Why Choose Nemours Children’s Hospital

Families from Central Florida, the Southeast, across the country and around the globe come to Nemours Children’s Hospital in Orlando’s Lake Nona Medical City because of our comfortable, high-tech facility and our pediatric specialists and surgeons who are consistently recognized among the very best in clinical care, many of whom are also engaged in world-class research.

 
Highlights of Our Pediatric Gastroenterology Care

Highlights of our pediatric gastroenterology care:

  • world-class facilities featuring the latest gastroenterology diagnostic techniques and equipment available
  • expertise in treating minor to extremely complex gastrointestinal problems including neuromuscular disorders and chronic and acute conditions of the stomach and esophagus, intestines, liver, gallbladder and pancreas
  • lead/participate in multidisciplinary clinics and programs to evaluate and treat  digestive health issues and related conditions such as obesity, aerodigestive disorders, cystic fibrosis, motility disorders and others
  • advanced pediatric medical imaging services available onsite
  • academic medical center means we’re at the leading edge of pediatric gastroenterology research and able to treat highly complex pediatric conditions
  • fully equipped pediatric operating rooms with board-certified pediatric anesthesiologists
  • experienced in innovative surgical techniques that minimize surgery risks, recovery time and pain
  • extensive imaging and navigational equipment for precise instrument guidance
  • customized treatment plans based on research and best practices
  • strong, meaningful relationships with community primary care doctors

Learn More about GI Care at Nemours Children’s Hospital »

 
Your Child’s Pediatric IBD Team

Our gastroenterologists work together with you and your family, and also with a team of specialists, advanced practice nurses and physician’s assistants to provide comprehensive care. Depending on your child’s condition, your child’s team may also include:

Because of our award-winning electronic health record system, we can instantly consult with Nemours experts throughout Florida and at our sister hospital, Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del., to pool our resources for the best care for your child no matter how complex the condition.

Inflammatory Bowel Disease (IBD) in Children

Inflammatory bowel disease (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 such as 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.

For your convenience, many of the same specialists you see at Nemours Children’s Hospital also offer care at Nemours Children’s Specialty Care locations in downtown Orlando, Lake Mary, Melbourne and Lakeland.

Advanced IBD Evaluation & Diagnostics at Nemours Children's Hospital

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 may include imaging studies, interventional radiology, blood tests and others to pinpoint what’s causing your child’s IBD, whether it’s Crohn’s disease or ulcerative colitis.

 
Diagnostic Tests and Procedures

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, or poop)
  • barium study/X-rays (involves drinking a thick liquid called barium that shows up white on X-ray images, to view parts of the intestine that can’t be reached in a colonoscopy and endoscopy)
  • computed tomography, or "CT" including 2-D and 3-D technology (to view cross-sectional images, called "slices," of organs, bones, blood vessels and soft tissues)
  • magnetic resonance imaging, or "MRI" and magnetic resonance enterography, or "MRE" (a special imaging test that allows us to see if the gastrointestinal tract is inflamed without exposure to radiation)
  • colonoscopy (a long, thin tube with a small camera called a "colonoscope" is inserted into the rectum to look for inflammation, ulcers or bleeding in the colon)
  • endoscopy, including esophagogastroduodenoscopy (a long, thin tube with a small camera called an "endocscope" is inserted through the mouth to view the esophagus, stomach and upper small intestine for signs of IBD)
  • 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)

Managing IBD in Children

Inflammatory bowel disease can be very painful for children and adolescents — physically and emotionally. Once your child has 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.

Once we relieve your child’s IBD symptoms, the next course of treatment focuses on managing the condition for fewer flare-ups using a combination of proven therapies that include nonsurgical and surgical options.

 
Prescription Medications

Certain prescription medications can manage flare-ups of IBD in children, including:

  • 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 medicine combination. But with careful attention and follow-up with our experienced Nemours medical team, we’ll get your child’s IBD symptoms under control.

 
Nutritional Support

Although changing your child’s diet won’t "fix" IBD, nutrition plays a large 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

The nutritionist/dietitian may accomplish this through diet plans, intravenous nutrition or tube feeding. Our team will work with you to create a plan specific to your child’s needs.

 
Surgery for Inflammatory Bowel Disease

The first line of treatment for IBD in children is almost always medication and nutritional support. If nonsurgical treatments don’t work or stop working, surgery can be an 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

To treat 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 percent of children with ulcerative colitis will need surgery at some point.

Our experienced pediatric surgeons at Nemours Children’s Hospital successfully perform GI procedures including state-of-the art minimally invasive surgical techniques.

Learn More About Pediatric Surgery at Nemours Children’s Hospital »

 
Behavioral Health for the Entire Family

From the start, our behavioral experts (psychologists and psychiatrists) make sure your child and family understand what’s happening throughout the entire care process and help you cope with the diagnosis and the affects of the disease and treatment. Psychological services may include cognitive behavioral therapy and/or psychotherapy (individual, group and family) to help your child and family adjust to treatment, manage pain, comply with taking medications and cope with depression and anxiety.

Learn More About Behavioral Health at Nemours Children’s Hospital »

 
Ongoing Treatment and Care for Your Child’s IBD

IBD in children is a chronic disease that requires ongoing follow-up and care. At Nemours Children’s Hospital, a big part of our IBD treatment involves educating your child and family about the condition, helping you find community resources and providing you with the tools necessary to successfully control this lifelong condition.

During follow-up visits, our team will 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 care. This means we help young people understand their diagnosis, treatments and other aspects involved with having a chronic medical condition so they can become healthy adults with IBD.