Crohn’s disease, part of a group known as inflammatory bowel diseases (IBD), is increasingly being diagnosed in children. This condition leads to chronic inflammation of the digestive tract. Dr. Seth Iskowitz, a pediatric gastroenterologist at Henry Ford Health, recently addressed this issue in a blog on the hospital’s website.
“Crohn’s disease is becoming more common in younger patients,” says Dr.Iskowitz. “The majority of children are diagnosed in their early teens, but it can sometimes present much earlier.”
What is Crohn’s disease?
- Crohn’s disease is characterized by ongoing inflammation of any part of the digestive tract.
- It affects nearly half a million people in the U.S., with a rising number of cases in children, particularly in their early teens.
- In children, it frequently targets the last part of the small intestine and the large intestine.
- While the exact cause remains unclear, there is strong evidence pointing towards genetics playing a significant role. Children with a family history of inflammatory bowel disease (IBD) are at higher risk.
“Kids are likely born with a genetic predisposition to Crohn’s disease,” says Dr. Iskowitz. “Parents often worry that it’s something they did or something they fed their child, but if you have a genetic predisposition, it’s usually just a matter of time before the disease presents itself.”
What does Crohn’s disease look like in kids?
The symptoms of Crohn’s can vary widely among children, including periods of remission.
“We often see kids whose only symptom is that they are not growing. This happens when the inflammation is in the small intestine,” says Dr. Iskowitz. “It’s the small intestine’s job to absorb the nutrients kids need to grow, but inflammation can interfere with this absorption.”
Notable symptoms include:
- Growth delays: This may result in delayed puberty in pre-adolescents and loss of menstrual cycles in teens.
- Digestive issues:
- Bloody stools
- Loss of appetite
- Stomach pain
- Anemia: Weakness due to not absorbing iron in food is common.
Diagnosing Crohn’s disease in children
“We usually start with a stool test to look for signs of infection or inflammation,” says Dr. Iskowitz. “But in order to accurately diagnose Crohn’s, we need to look at the entire gastrointestinal (GI) tract.”
The diagnosis of Crohn’s disease involves a comprehensive approach which can include:
- Initial tests: A stool test is typically the first step to look for signs of infection or inflammation.
- Further examination: A thorough examination of the gastrointestinal tract is necessary. Your child may require one or more of the following:
- Colonoscopy (for the lower GI tract)
- Esophagogastroduodenoscopy (EGD) (for the upper GI tract)
- MRI enterography (MRE) (for detailed images of the entire GI tract)
Treating Crohn’s disease in kids
Depending on the severity of symptoms, children are treated with methods that are tailored to their specific needs. Your child’s treatment plan may include:
- Medication: The cornerstone of treatment, aimed at reducing inflammation and maintaining remission.
- Lifestyle adjustments: When diet changes alone don’t maintain remission, incorporating stress management techniques can be helpful.
- Surgery: In rare instances, surgery may be required to remove parts of the bowel that are severely affected and not responsive to medication.
Ongoing care and management
Effective management of Crohn’s disease in children requires a multidisciplinary approach to keep it in remission. For example:
- Regular monitoring: Adjustments in medication and treatment strategies are often needed, especially as children grow and develop.
- Team-based approach: A collaborative care team, including a pediatric gastroenterologist, nutritionist, psychologist and other specialists is important for comprehensive treatment.
Managing Crohn’s disease in children is a lifelong journey, focusing on achieving and maintaining remission.
“We can’t cure Crohn’s disease, but the vast majority of kids respond well to medication,” says Dr. Iskowitz. “The goal is to put them into complete remission where they no longer have any symptoms.”
To learn more visit henryford.com. Metro Parent has the latest information on children’s health here: metroparent.com/top-kids-health-questions/
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