Treating Pediatric Inflammatory Bowel Diseases (IBD)
Pediatric Gastroenterology
Inflammatory Bowel Diseases (IBD) are diseases where the immune system is abnormally triggered to cause long-term inflammation within the gastrointestinal tract (GI tract). There are two major types of IBD:
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Crohn’s disease: the inflammation can affect any part of the GI tract, from mouth to anus, affecting some, but not others. It can affect the entire thickness of the wall of the intestinal tract.
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Ulcerative colitis (UC): the inflammation affects primarily the large intestine (colon) and involves the superficial layer of the lining.
Symptoms
Depending on which type of IBD and which part of the GI tract is inflamed, the symptoms of IBD can vary from child to child:
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Poor growth
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Long-standing fevers
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Long-standing diarrhea
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Bloody diarrhea
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Sores in the mouth or around the anus
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Long-standing abdominal pain with any of the above problems
Causes
The exact cause of IBD is still not known, but we know that genetics, environment, bacteria, and diet play important roles. A combination of factors abnormally triggers the immune system to start to attack the lining of the GI tract and then this inflammation causes the various symptoms.
Diagnosis
We use a combination of techniques, starting with asking a lot of questions, getting an accurate description of growth and symptoms, and getting to know more about other illnesses in the family. Also, a physical exam is necessary. Lab tests, esophagogastroduodenoscopy, and colonoscopy are also helpful. Sometimes, additional imaging of the bowels is done.
Treatments
Treatment of IBD is aimed at removing the inflammation. If the inflammation is superficial and limited, drugs like aminosalicylates can be used, particularly for patients with UC. For more deep or widespread inflammation, treatment is targeted at taming the immune system which is actually causing the inflammation from within. There are many drugs that affect the way that the immune system is working; some medications come as pills, some are given intravenously, and others are shots. There are also diets prescribed for certain patients with IBD, depending on their age and type of disease. Get a brief overview of the different medications so that you can be better prepared to discuss this with your doctor.
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