Pediatric Crohn’s disease is Crohn’s disease that affects those younger than 18 years old.

Crohn’s disease is a type of inflammatory bowel disease (IBD) that can affect any part of the digestive system between the mouth and the anus. It often appears for the first time in adults, but a quarter of those with the condition receive a diagnosis before the age of 18 years.

Here, we examine pediatric Crohn’s disease, how it affects people, diagnosis, treatment options, and more.

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Crohn’s disease is a type of IBD that can affect any part of the digestive tract. It usually appears in adults but can begin before the age of 18 years. This is known as pediatric Crohn’s disease.

Age of diagnosis

Most diagnoses of pediatric Crohn’s disease are known as adolescent onset and appear during the teenage years. However, Crohn’s disease can affect much younger children and infants.

Very early onset Crohn’s disease occurs when a person receives a diagnosis before the age of 6 years. When a diagnosis occurs in someone younger than 2 years old, doctors refer to the condition as infantile-onset Crohn’s disease.

Symptom differences

In adults, symptoms often affect the small intestine only.

However, in younger children, they are more likely to affect other parts of the digestive tract, particularly the large intestine. Symptoms may also be more resistant to treatment in this population.

Symptoms that appear in adolescents are more likely to resemble those of adults.

Generally speaking, the signs and symptoms of Crohn’s are similar in children and adults, but there may be additional challenges for younger people.

As with adults, there is a wide variation in symptoms and how they affect an individual.

The symptoms may appear suddenly or build up over time. There may also be times of remission when symptoms improve or disappear for a while.

Symptoms related to the intestinal tract

A child with Crohn’s disease may experience:

In some cases, an area of the gastrointestinal tract can narrow, which may lead to a blockage. Signs of a blockage include:

A blockage is a medical emergency and needs urgent attention.

Perianal disease signs

Around 30% of children with Crohn’s disease develop perianal disease, which can cause the following:

Other symptoms

Chron’s symptoms can also affect other parts of the body.

Around 40% of those with pediatric Crohn’s disease develop symptoms in the mouth, such as:

  • canker sores
  • swelling
  • lesions on the mouth and gums, known as mucogingivitis

Other symptoms include:

Experts do not know exactly why Crohn’s disease happens, but a combination of genetic, environmental, and immune-related factors likely contribute.

  • Genetic factors: Around 15% of people with pediatric Crohn’s disease have another family member with Crohn’s. Some genetic features may make Crohn’s more likely to appear under certain conditions.
  • Environmental factors: Bacterial or viral infections may trigger Crohn’s in those with certain genetic features.
  • Immune factors: An infection or other trigger may start an overactive immune response. As a result, the immune system mistakenly starts attacking healthy tissue in the digestive tract and continues to do so.

Triggers for a flare

Symptoms may not be present all the time. Factors that may trigger or worsen symptoms include:

If a child has symptoms that could indicate Crohn’s disease, a doctor may:

  • ask about their symptoms
  • ask about individual and family history
  • perform a detailed physical exam

They may also perform the following tests:

  • a stool test
  • imaging tests, such as an X-ray, CT, MRI, or ultrasound scan
  • an endoscopy, which involves inserting a thin tube with a camera on it inside the digestive tract
  • a video capsule endoscopy, where the child swallows a capsule containing a tiny camera that emits images from inside the digestive system

Treatment for pediatric Crohn’s disease involves a team of specialists, including:

  • a pediatrician
  • pediatric gastroenterologists, who specialize in children’s digestive conditions
  • dieticians and nutritionists
  • psychologists and counselors, as living with Crohn’s can affect many areas of a child’s life

Treatment options will depend on the individual and how Crohn’s affects them. However, they may include:

Learn about the link between Crohn’s and vitamin B deficiency.

Living with pediatric Crohn’s disease can be challenging.

The effects of Crohn’s on the body, as well as treatment and other adjustments, may affect school life, participation in activities, self-image, and other key areas of life.

Counseling, such as cognitive behavior therapy (CBT), and making a plan with their school can help support a young person and manage or reduce the risk of depression and anxiety, which is higher among young people with irritable bowel disease (IBD).

A child or young person may need medical help if they experience ongoing abdominal pain or other signs that could indicate Crohn’s disease.

It is also important to contact a doctor if a person has a diagnosis of Crohn’s and experiences severe or worsening symptoms.

For example, the following can be signs of an intestinal blockage, which requires urgent attention:

  • severe pain
  • nausea
  • vomiting

A young person with Crohn’s disease who finds it difficult to cope at school or in relationships may benefit from speaking with a specialist counselor.

Learn how to recognize a Crohn’s disease flare-up.

Crohn’s disease is a lifelong condition that progresses in stages and can worsen over time. There is currently no cure, but treatment can help people manage the condition. A person may need treatment for the rest of their life.

Crohn’s affects individuals differently, and a person’s outlook can vary widely. Many people need surgery at some point in their life. Around half of those with pediatric-onset Crohn’s will likely need surgery before the age of 30 years. Many people need surgery more than once as symptoms recur.

Crohn’s disease also increases the risk of colon cancer. Some experts recommend screening for colon cancer every 1 to 2 years, starting 7 to 10 years after an initial diagnosis of pediatric Crohn’s disease.

With appropriate support, many children with Crohn’s can live a full life alongside their peers.

Here are answers to some questions people often ask about pediatric Crohn’s disease.

Can pediatric Crohn’s disease go away?

Pediatric Crohn’s disease is a lifelong condition, and there is currently no cure. However, many people experience periods of remission, in which symptoms improve. Treatment can often help manage symptoms and improve the chances and duration of remission.

How rare is pediatric Crohn’s disease?

Some sources say pediatric Crohn’s disease is rare.

A 2018 study states that the prevalence is 58 per 100,000 children, which would mean there are about 42,000 children under the age of 18 with Crohn’s disease in the United States.

What is the life expectancy with pediatric Crohn’s disease?

This will depend on how Crohn’s affects the individual, as well as treatment options and many other factors.

In one study, those who received a diagnosis of IBD — either Crohn’s or ulcerative colitis — had a life expectancy that was 2.2 years lower than those without IBD by the age of 65.

However, this is a relatively small difference and includes people who received their diagnosis in 1964, when treatment options were far more limited.

IBD resources

Visit our dedicated hub for more research-backed information and in-depth resources on inflammatory bowel disease (IBD).

Pediatric Crohn’s disease is when a person receives a Crohn’s diagnosis before the age of 18 years.

The symptoms of the condition and how they affect an individual can vary widely, although children and infants may face additional challenges. Crohn’s can affect growth, physical development, and mental well-being at this age.

Crohn’s is a lifelong condition, and there is currently no cure. Still, medication and other treatment options can help manage symptoms and give a person a good quality of life.