Inflammatory Bowel Disease Treatment and Management in Children
Inflammatory bowel disease (IBD) is a chronic gastrointestinal (GI) condition that affects the gastrointestinal tract. It includes conditions such as Crohn's disease and ulcerative colitis.
At RWJBarnabas Health, our highly trained
pediatric gastroenterology specialists provide expert care for children with pediatric IBD, and ensure
that they receive the best possible treatment and support.
What Is Pediatric IBD?
Pediatric inflammatory bowel disease is a chronic inflammatory condition of the gastrointestinal tract diagnosed in children. The primary types of IBD are Crohn's disease and ulcerative colitis. Sometimes, it can be difficult to distinguish between the two, and this is referred to as indeterminate colitis. Over time, many children with indeterminate colitis are diagnosed with either Crohn's or ulcerative colitis.
Types of Pediatric IBD We Treat
- Crohn's disease. Involves inflammation of any part of the gastrointestinal tract, from mouth to anus, often affecting multiple layers of the bowel wall.
- Ulcerative colitis. Affects the colon and rectum, typically involving only the colon's innermost lining.
- Indeterminate colitis. Diagnosed when it is unclear whether the condition is Crohn's disease or ulcerative colitis.
- Very early onset IBD. Diagnosed in children younger than 6 years, often associated with severe symptoms and linked to genetic mutations in the immune system.
Causes of Pediatric IBD
The exact cause of IBD in children has yet to be entirely understood. It involves a combination of genetic factors, environmental triggers and immune system dysfunction. Normally, the immune system defends against infections in the gastrointestinal tract, but in IBD, it remains active and causes damage even in the absence of infection, leading to chronic inflammation and tissue damage.
Pediatric IBD Symptoms
Symptoms of IBD vary depending on the location and severity of the inflammation and can differ between Crohn's disease and ulcerative colitis. Common symptoms in children include:
- Abdominal pain, often in the lower abdomen
- Diarrhea with or without blood
- Urgency to pass a bowel movement, sometimes waking children at night
- Weight loss or poor weight gain
Symptoms can also occur in areas of the body beyond the abdomen, such as:
- Unexplained fevers
- Painful red eyes
- Joint pain or swelling
- Rashes on the lower legs
- Poor growth in height
Diagnosis of Pediatric IBD
Diagnosing IBD in children involves various tests:
- Blood tests for anemia, protein or albumin levels, and inflammatory markers (for example, C-reactive protein, erythrocyte sedimentation rate)
- Stool tests for markers of inflammation (for example, fecal calprotectin) and to rule out infections
- Upper endoscopy and colonoscopy with biopsies
- Capsule endoscopy and imaging studies like MRI of the intestines (MRE) to determine disease location and severity
Treatments for IBD in Children
There is no cure for IBD, but it can be managed. Our pediatric gastroenterologists tailor treatment and management plans to each child based on disease type, location and severity. Treatment options include:
- Medications with broad effects on the immune system (prednisone, methotrexate, 6-mercaptopurine)
- Biologic agents targeting specific inflammatory chemicals (TNF inhibitors, interleukin inhibitors, anti-integrins)
- Small molecules affecting immune response (JAK inhibitors, sphingosine 1-phosphate receptor modulators)
- Supportive measures such as dietary changes or supplements
- Surgery for complications like severely damaged intestine, blockages, abscesses, or fistulas
Support Services for Pediatric IBD
We offer support services for pediatric patients with IBD including dietary counseling, psychological support and patient education to help manage the disease and improve each child's quality of life.
Screening for Pediatric IBD
There is no known way to prevent IBD. Early diagnosis and treatment are crucial for managing symptoms and preventing complications. Regular screenings and monitoring are recommended for children at risk or those who show symptoms.
Expert Care for Pediatric IBD
If your child is experiencing symptoms of inflammatory bowel disease, seek medical advice promptly. Early diagnosis and treatment are essential for managing the disease and improving your child's quality of life. Contact RWJBarnabas Health today to schedule an appointment with our pediatric gastroenterology specialists.