Inflammatory Bowel Disease
Inflammatory bowel disease, or IBD, is not to be confused with IBS, or irritable bowel syndrome. IBD is a chronic condition that may include severe belly pain, blood in the stool and weight loss. IBS is also a chronic condition that can include belly pain, diarrhea or constipation, but does not include weight loss or blood in the stool.
What is inflammatory bowel disease?
Inflammation occurs when the body tries to fight against something that is invading or attacking it by releasing white blood cells and chemicals. This causes redness, swelling, pain, and loss of function in the affected area. In IBD, the inflammation occurs in different parts of the bowel, or intestine. Because of the activation of the cells and chemicals, there can be symptoms that include other parts of the body, as well at the bowel. These diseases can have flares, or times when the symptoms are worse, alternating with times when they are much better.
The two diseases that make up IBD are Crohn’s disease and Ulcerative colitis. The symptoms that occur with these can be very similar: abdominal pain, diarrhea, bloody stool, fever, weight loss, growth delay, arthritis, liver disease, or skin problems. There are some differences between the two. In Ulcerative colitis only the colon is affected, there are no gaps of healthy tissue between affected areas, and it only affects the inner lining of the colon. Crohn’s disease can occur anywhere in the GI tract, can occur at different spots at the same time, and can involve the whole thickness of the area.
What causes IBD?
We’re not sure of the exact cause of IBD, but it appears to be a combination of the immune system, genetics, and environmental factors.
How common is IBD?
IBD affects about 60,000 children in the United States. Children with a close relative with IBD are slightly more likely to develop it themselves.
How is IBD diagnosed?
Generally, children with IBD-like symptoms are referred to a gastroenterologist for diagnosis and treatment. Your general pediatrician can do stool studies or check blood labs, but gastroenterologists are more experienced at interpreting the particular labs for IBD. Gastroenterologists are also able to look directly at the colon or esophagus/stomach with endoscopes, which also allow them to take samples of areas, as needed, for more accurate diagnosis. Your gastroenterologist
How is IBD treated?
The goals of treatment are to induce remission, keep them in remission if possible, and treat flares/inflammation. The actual treatment depends on where in the GI tract the disease is, how bad it is, and if it includes other areas of the body. For mild disease there are some strict diets that may be helpful. Otherwise treatment may include non-steroid drugs that limit inflammation, steroids, or immunomodulators or biologics. Surgery may be required to remove areas that do not respond to other treatment.
IBD is a chronic disease that will remain with the child their entire life, but does not truly shorten their life. However, the nature of the disease and/or treatment can lead to growth and weight issues, nutritional deficiencies, infections, or cancer. The child’s gastroenterologist and pediatrician work together to watch for and manage these issues. Having a chronic, often painful disease can lead children to feel isolated, anxious, or depressed, so having access to support groups, counselors, and other services can certainly help.
Bottom line.
Inflammatory bowel disease is often a serious condition needing a gastroenterologist for treatment. If you think your child has this, discuss it with your pediatrician.
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