Inflammatory bowel disease (IBD) is a lifelong condition that causes inflammation in the gastrointestinal tract (GI). While often diagnosed in adolescents and young adults, more young children are now developing IBD.
IBD is a common condition, affecting around
Early detection is essential to prevent complications such as malnutrition or growth delays.
This article explores IBD in children, looks at the symptoms and discusses the causes and possible complications associated with IBD in children.
Symptoms also differ from child to child, similar to symptoms an adult may experience. Common symptoms include:
- abdominal pain
- blood in the stool
- nausea and vomiting
- loss of appetite, which can lead to weight loss
- growth failure
- perianal disease
- extra-intestinal symptoms, such as:
Pediatric-onset IBD may be more severe and has increased disease activity than adult-onset IBD.
The following factors
- disease activity
- age of onset
- perianal involvement
- C-reactive protein levels
- pubertal stage
Children with IBD may not grow as well as others and go through puberty later. According to a
The exact cause of IBD is not clear. However, a
IBD also tends to run in families. A family history of UC and Crohn’s is present in up to
Close family members of a person with IBD have a 1 in 3 chance of developing IBD. Moreover, genetic factors may also play an essential role in early onset-pediatric IBD than adult-onset IBD. There are
However, not all people with IBD have a family history of the condition. Other contributing factors may cause IBD to develop.
A doctor will conduct a thorough health history and physical examination and use a
- Blood tests: This looks for conditions such as anemia and signs of inflammation in the body.
- Stool studies: These check for blood in the stool, infection, and signs of inflammation in the child’s intestines.
- Imaging tests: These include CT scans and MRI scans to look for inflammation, swelling, blockages, and narrowing in the intestines.
- Barium swallow: This test requires a child to swallow a barium fluid to coat the inside of the organs in the upper GI tract.
- Barium enema: This test coats the large intestines, including the colon and rectum, to examine narrowed areas called strictures.
- Upper endoscopy or colonoscopy: This procedure uses a small flexible tube with a tiny camera called an endoscope to see inside the tract. A doctor can take a biopsy or tissue sample for testing.
- Capsule endoscopy: This procedure involves the child swallowing a special capsule, and a camera takes photos of the small intestine.
The treatment program will depend on the location and severity of the child’s condition and whether they have UC or Crohn’s.
Treatment goals for IBD in children include:
- eliminating symptoms and restoring quality of life
- correcting nutritional deficiencies to restore average growth
- preventing future flare-ups and inducing remission
- healing the intestines
- eliminating or preventing complications
Doctors may recommend a range of nonsurgical and surgical treatments for a child, including:
A doctor may give a child different medications depending on their symptoms. These include medicines for pain, inflammation, diarrhea, and vomiting. They may also get drugs to prevent infection and stop their immune system from attacking their bodies.
Nutrition and supplements
Many children with IBD do not absorb enough nutrients, which may lead to vitamin deficiencies. Doctors may perform tests to assess their nutrient levels and recommend specific vitamins and minerals or special shakes or drinks to meet their nutritional needs.
Exclusive enteral nutrition
Intestinal inflammation makes it difficult for a child’s body to absorb the nutrients needed to help them grow. Doctors may therefore give children 100% of their nutritional needs in a liquid formula through a nasogastric tube to feed them. Children usually receive this treatment for 6–12 weeks to give the GI tract enough time to heal.
Certain foods can also trigger or worsen IBD. Children may use a particular meal plan or avoid certain foods that may cause a flare.
A child may need surgery if they develop complications, including:
- hole in the bowels
- strictures or blockages
- continuous bleeding
- bowel obstructions
- bowel resections
- symptoms do not respond to conservative treatments
IBD symptoms may come and go. A child can go months to years without any symptoms, called remission. However, symptoms can also reappear, called a flare.
Below are things that can help manage flares:
- Keep the child hydrated: Hydration is a common issue in children with IBD, especially those with diarrhea. A child should drink water and electrolyte drinks to hydrate, but avoid sugary drinks as they may worsen symptoms. Read more about the benefits of drinking enough water.
- Balanced nutrition: Easy-to-digest food can reduce the irritation of the digestive tract during a flare. Learn more about the low fiber diet.
- Prevent skin irritation and ulcers: Frequent diarrhea may irritate the anal area. Keeping the anal area clean and dry is essential to prevent ulcerations and irritation. A person may also apply a zinc-oxide treatment to protect intact skin.
- Consult with a pediatrician: It is essential to alert the doctor at the first sign of symptoms. Doctors can provide new medications or treatments and run tests to help determine the flare cause.
- Avoid nonsteroidal anti-inflammatory drugs (NSAIDs): Doctors will not prescribe NSAIDs for pain as they may worsen a flare but will provide pain relievers suitable for children.
IBD can occur at any age, but 1 in 4 cases occurs before a person is 20 years old. While children may experience similar symptoms to adults, a child with IBD is at an increased risk of developing certain other medical conditions, such as arthritis or malnutrition. Adults with childhood-onset IBD may also have slightly reduced heights compared to their peers.
While there is no cure for IBD, pediatricians can help manage symptoms with suitable medical treatments and lifestyle changes.