Crohn’s disease is a type of inflammatory bowel disease (IBD) that causes chronic inflammation in the digestive tract. In kids, it tends to cause diarrhea, stomach cramping, and a low appetite.
Crohn’s disease is rare in children, but it can be severe and affect many aspects of health. It is important for a child with any symptoms to receive medical attention.
Below, we look into how common this is in children and what its symptoms are. We also describe the possible genetic causes and how to treat and manage the disease.
Crohn’s is less common in children than adults. Like ulcerative colitis, it is a type of IBD.
Research from 2015 reports that
This suggests that eventually, most pediatric practices will treat at least one child with Crohn’s disease.
Crohn’s disease causes chronic inflammation in the digestive tract and sometimes other areas, such as the skin or genitals.
The most common symptoms in children include:
- painful stomach cramping
- frequent diarrhea, which may be watery
- bloody diarrhea
- anal or rectal pain
- a loss of appetite
Other health issues that can occur with Crohn’s disease include:
Crohn’s may affect a child’s appetite and make it more difficult to absorb nutrients. As a result, the child’s growth may slow or stop.
About 30% of teens and children with Crohn’s develop symptoms involving their anus, including pain, tears, or blockages.
Perianal disease can make it difficult to have a bowel movement. Also, tears and other injuries around the anus can lead to infections.
About 40% of children with Crohn’s develop oral symptoms, which means that the disease affects their mouth, including their gums.
A person may notice sores in the child’s mouth or swelling of their gums. The child may complain of mouth or tongue pain or have frequent dental problems.
Crohn’s-related inflammation can affect the eyes, causing swelling, itching, and burning in and around the eyes.
Some children develop a rash called erythema nodosum. This causes flushed skin and blisters or welts to form. These may develop in a cluster in a single spot, often the shins, or they may appear throughout the body.
Some children with Crohn’s develop joint inflammation that can cause chronic pain or difficulty moving.
Experts have not identified a single cause of Crohn’s disease. It may involve a mix of genetic and environmental factors.
Is it genetic?
Researchers have identified more than
Children with Crohn’s are more likely to have mutations in the genes NOD2 and CARD15. Preliminary research suggests that these genes may cause the disease to appear at a younger age.
Interactions between environmental factors, infections, and genetic factors may lead to Crohn’s. For instance, exposure to certain infections or environments may activate or change genes in ways that increase the risk of Crohn’s.
Some possible causes and risk factors
- Infections: Certain viruses and types of bacteria can damage the intestines, increasing the risk of Crohn’s disease.
- Intestinal bacteria: People with Crohn’s have less diverse populations of intestinal bacteria. Doctors do not know if this causes Crohn’s, or if Crohn’s affects this diversity.
- Race or ethnicity: In the United States, white people are most likely to be diagnosed with Crohn’s, and the diagnosis is rare in people of Asian or Hispanic descent. It is currently unclear whether this is a result of racial bias or a medical factor.
- Geographic location: Some
researchshows that industrializing areas of Asia and Africa are seeing increases in cases of Crohn’s disease.
No single test leads to a Crohn’s diagnosis — doctors use a variety of tests to check for Crohn’s-related inflammation and to rule out other issues.
A doctor may:
- take a complete medical history
- test the blood for infections and inflammatory markers
- perform an endoscopic exam with a thin, flexible tool to look at the intestines
Because Crohn’s and ulcerative colitis cause similar symptoms, differentiating one from the other can be challenging.
Treatment focuses on reducing the risk of complications, such as nutritional imbalances, and addressing the inflammation that causes Crohn’s symptoms.
A doctor can prescribe medication to curb this inflammation, slow damage to the digestive system, and reduce symptoms, including secondary symptoms such as skin issues.
One drug that doctors may recommend for children with mild to moderate Crohn’s symptoms is 5-aminosalicylic acid, known as 5-ASA. Kids with more severe symptoms may require corticosteroids.
Other Crohn’s medications suitable for children and teenagers include:
More treatment options include:
- Supplemental nutrition: A doctor may recommend liquid nutrition, vitamins, or even intravenous fluids.
- Pain medication: Some children need pain medication to manage symptoms of Crohn’s.
- Diarrhea medication: This type of medicine can help with this common Crohn’s symptom.
There is, so far, no cure for Crohn’s disease. The following strategies may help with managing the symptoms:
- Education: Talk with the child about the disease. This can make it seem less scary and ease anxiety about bowel accidents. A parent or caregiver may also need to advocate for the child at school.
- Preparation: Have the right supplies on hand to manage Crohn’s flares and accidents. Some children feel more comfortable wearing pull-ups, while others may need to carry a change of clothes.
- Identifying triggers: Try keeping a log of the child’s Crohn’s symptoms, their diet, and any other factors that seem relevant. This can help with identifying triggers. Once this is done, work with the child and their doctor to find ways to reduce or control their exposure to these triggers.
Crohn’s disease can be frightening, especially for young children who may struggle with bowel control and potty training.
It is a lifelong condition, but medication and lifestyle changes can treat it, causing it to go into remission.
Any child who has possible Crohn’s symptoms should receive medical attention.