Crohn’s Disease Treatment and Management in Children
Crohn's disease is a gastrointestinal (GI) condition that affects the gastrointestinal tract. The disease is typically moderate to severe in children, and can cause pain or other symptoms that affect the child's health and quality of life.
At RWJBarnabas Health, our pediatric gastroenterologists understand the unique challenges that Crohn’s disease presents in children. With sensitivity and compassion, our team of GI specialists can help your child manage this chronic condition.
What Is Crohn’s Disease?
Pediatric Crohn’s disease is a chronic inflammatory bowel disease (IBD) can affect any part of the gastrointestinal tract and often extends deeper into the layers of the bowel wall. In children, the disease often involves the end of the small intestine (terminal ileum) and the beginning of the large intestine (colon).
Pediatric Crohn’s Disease Causes
The exact cause of pediatric Crohn’s disease is not entirely understood. It is believed to result from a combination of genetic factors, environmental triggers, and an imbalance in the immune system. In IBD, the immune system mistakenly attacks the gastrointestinal tract, leading to chronic inflammation and damage.
Pediatric Crohn’s Disease Symptoms
Symptoms of pediatric Crohn’s disease vary depending on the location and severity of the inflammation. Common symptoms include:
- Abdominal pain, often in the lower right part of the abdomen
- Diarrhea, which can sometimes be bloody
- Significant weight loss or poor weight gain
- Unexplained fevers
- Painful red eyes (uveitis, episcleritis)
- Joint pain or swelling, especially in larger joints like knees and elbows
- Rashes, particularly on the lower legs
- Stunted growth
- Pain around the anus due to abscesses or fistulas
Pediatric Crohn’s Disease Diagnosis
Diagnosing pediatric Crohn’s disease involves several tests, including:
- Blood tests to check for anemia, protein levels, and inflammatory markers (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR))
- Stool tests to detect inflammation and rule out infections
- Endoscopic procedures, such as upper endoscopy and colonoscopy with biopsies or capsule endoscopy
- Imaging studies like MRI of the intestines (MRE) to assess the location and severity of the disease
Pediatric Crohn’s Disease Treatments
There is currently no cure for pediatric Crohn’s disease, but effective management is possible. Treatment is individualized based on the child's specific needs and the severity of the disease.
Treatment options include:
- Medications that regulate the immune system (prednisone, methotrexate, 6-mercaptopurine)
- Biologic therapies targeting specific inflammatory chemicals such as tumor necrosis factor (TNF), interleukins (IL 12 and 23), anti-integrins
- Small molecule medications that reduce inflammation (JAK inhibitors)
- Dietary modifications, which may involve exclusive enteral nutrition or other specific diets (for example, the Mediterranean diet, Crohn’s disease exclusion diet)
- Surgical interventions to address complications such as strictures, abscesses or fistulas
Crohn’s Disease Support Services
At RWJBarnabas Health, we offer support services for children with Crohn's disease and their families, including nutritional counseling, psychological support, and access to support groups. We aim to help manage the disease and improve our young patients' overall quality of life.
Screening and Continuous Disease Management
While no specific measures exist to prevent pediatric Crohn’s disease, early diagnosis and ongoing monitoring are crucial. Regular check-ups and screenings, including blood tests, stool tests, and imaging studies, help manage the disease and prevent complications.
Compassionate Pediatric Crohn’s Disease Care
If your child is experiencing symptoms of Crohn’s disease, our team at RWJBarnabas Health is here to help. Schedule an appointment with one of our pediatric gastroenterology specialists to discuss evaluation and treatment options. Early intervention can significantly improve your child's health and well-being.