Inflammatory
Bowel Disease (IBD) in Children
What
is it?
Inflammatory bowel disease (IBD)
is a general name for diseases that cause the
intestine to become inflamed, causing abdominal
cramps and diarrhea. The two most common forms of
IBD are Crohn’s disease and ulcerative colitis.
Crohn’s disease usually occurs in the lowest
part of the small intestine, called the ileum, as
well as the large intestine.
However, it can affect any part of the
digestive tract, from the mouth to the anus.
Crohn's disease is sometimes called ileitis or enteritis.
With ulcerative colitis, only the inner
lining of the large intestine becomes inflamed,
swollen, and ulcerated.
The inflammation usually begins in the
lower end of the large intestine, called the
sigmoid colon, which empties into the rectum. When
the rectum and large intestine become inflamed,
water can’t be absorbed into the blood stream,
which causes diarrhea.
Eventually, the inflammation spreads
throughout the large intestine, with the exception
of the last section called the ileum.
The small intestine is not affected in
ulcerative colitis.
Who
gets it?
Both boys and girls can get
an IBD. If
someone in your family suffers from an IBD, other
family members have a 20% chance of also having
the disease. Most
people are diagnosed between the ages of 15 and
40.
What
causes it?
No one is sure what causes
IBD.
However, researchers believe it may be caused by an
overactive immune response in the intestine.
The immune system attacks the intestine,
which causes the inflammation. Some
researchers believe some type of viral, bacterial,
or fungal organism sets off the cycle of the
ulcerative colitis. IBD is not contagious,
however.
What
are the symptoms?
The most common symptoms of
an IBD are abdominal pain and diarrhea.
Symptoms may be mild and come and go.
In some cases, symptoms are severe and
include fever, bloody stools, weight loss, anemia,
and fatigue. Symptoms of Crohn’s disease in
children generally include joint pain, fever,
anemia, and slow growth. Other
complications of Crohn’s and ulcerative colitis
can include ulcers in and around the mouth, skin
rashes, and eye inflammation.
These symptoms improve with treatment of
the intestinal inflammation.
How
is it diagnosed?
An IBD is diagnosed by taking
a thorough medical history and detailed list of
symptoms. Because
the inflammation of the intestine can be caused by
disorders other than ulcerative colitis, stool and
blood samples are important methods to determine
whether the symptoms are caused by a bacterial or
parasitic infection.
Blood tests may also reveal anemia in cases of severe blood
loss. The
best way to confirm a diagnosis and locate the
area of infection is through a procedure called
endoscopy. A
tiny, flexible viewing tube inserted through the
rectum and into the colon lets the doctor examine
the lining of the intestine.
He or she can also take a small sample
(biopsy) of the intestine to examine under a
microscope for inflammation. An
endoscopy is usually performed under general
anesthesia. Your
doctor may also order a barium x-ray after
treatment has begun to get a better view of the
intestine. Barium
is a chalky liquid that your child will either
drink or have inserted as an enema through a tube
in the rectum before the x-ray.
What
is the treatment?
There is no true cure for IBD,
although severe cases of ulcerative colitis can be
cured by removing the colon.
Treatment is aimed at controlling and
reducing symptoms.
Treatment usually begins with some type of
oral drug, such as sulfasalazine or mesalamine,
which reduces inflammation and helps stop
flare-ups. These
drugs can be given as pills, liquids, and,
sometimes, suppositories.
Children who don’t respond to these drugs
may be given steroid medications, such as
prednisone. If
prednisone is used, the goal is to slowly reduce
and then stop the steroid and continue the
sulfasalazine or mesalamine.
It’s best to avoid foods that irritate
the intestines, such as nuts, popcorn, or raw
vegetables. Doctors frequently recommend
nutritional supplements and special high-calorie
liquid formulas, especially for children with
delayed growth.
In severe cases, children may need to be
hospitalized.
Treatment might include a nasogastric tube for removal of
stomach juices and for feeding, intravenous fluids
for dehydration, and antibiotics to fight
infection. Surgery is recommended only in severe
cases where other treatments are not working or in
cases where your child’s growth is substantially
delayed. Surgery
for ulcerative colitis involves removing all or
most of the large intestine. While
the intestine heals, the intestine
temporarily drains stool
through an opening in the abdomen called a stoma. A
special bag placed over the opening collects the
liquid stool.
Usually, the stoma is temporary.
After the intestine has healed, another
surgery will reconnect the remaining intestine to
the rectum so that normal bowel movements can
resume. In
Crohn's disease, the surgeon usually removes the
diseased section of the intestine and joins the
remaining healthy sections together. However,
while surgery may relieve symptoms of Crohn’s
disease indefinitely, it is not a cure. The
inflammation tends to return next to the area of
intestine that has been removed.
Self-care
tips
If your child has been
diagnosed with an IBD, it’s important to follow
your doctor’s recommended treatment plan.
Report any changes in your child’s condition immediately,
provide your child with a healthy diet, and make
sure he or she gets plenty of rest.
It’s important to make the school nurse
and teachers aware of your child’s condition so
he or she is able to use the bathroom as often as
necessary. Children
with an IBD can participate in normal activities
as long as they are feeling well.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
|
