INFLAMMATORY BOWEL DISEASE

WHAT IS IT?                                                              PDF> Inflammatory Bowel Disease (IBD)                          
Inflammatory Bowel Disease (IBD) is a chronic inflammation of the intestines that does not have an identifiable cause (such as infection). Pediatric IBD causes the immune system to become inappropriately active, causing injury to the intestines.

There are two main forms of IBD:

1. Crohn’s disease (CD)
2. Ulcerative colitis (UC)

• Around one out of 10 children have what’s called “indeterminate colitis,” which means that the doctor can’t definitively state whether the IBD is Crohn’s disease or ulcerative colitis.
• Over time, many of these cases are eventually diagnosed as one or the other.
• IBD may be mild, severe or anywhere in between.
  

SYMPTOMS

• Diarrhea, sometimes with blood and mucus
• Abdominal pain
  
• Loss of appetite and weight loss
  
• Unexplained fever and tiredness
  
• Delayed growth and maturation, particularly with Crohn’s disease
  

CAUSES
Although the exact cause(s) of IBD is not known, these are thought to play a role in both diseases:

• A genetic tendency
  
• An environmental trigger
  
• The patient’s immune system
  
• Bacteria that are normally in the intestine

DIAGNOSIS
The diagnosis of IBD may be suspected on the basis of the medical history, but the final determination depends on the results of diagnostic tests. The work up may include:

• Blood tests
• Stool cultures to rule out infection
• Endoscopy with biopsy of the upper and lower intestine
• X-rays

PREVALENCE

• IBD affects around 1.4 million Americans, including around 80,000–100,000 children and young adults.
  
• While many people confuse IBD with IBS (irritable bowel syndrome), they are very different conditions.

CROHN’S DISEASE AND ULCERATIVE COLITIS

CROHN’S DISEASE

Crohn’s disease can involve any part of the gastrointestinal tract, from the mouth to the anus.

 

 

ULCERATIVE COLITIS

Ulcerative colitis only affects the colon. It usually involves the rectum and can affect areas up into the colon. If it affects the whole colon (it is called pancolitis).

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UNDERSTANDING INFLAMMATORY BOWEL DISEASE

TREATMENTS FOR CROHN’S DISEASE AND ULCERATIVE COLITIS

MEDICATIONS
The aim of medication treatment is to decrease the inflammation causing damage to the intestines. Even though a medical cure is not yet possible, control of symptoms can be very effective in most patients.
There are two primary methods for using medication:

• Induction therapy is used to alleviate the symptoms of an IBD flare-up
  
• Maintenance therapy is used for long-term management of the disease
  

The most common medications used to treat IBD are:

• Antibiotics such as metronidazole and ciprofloxacin
  
• ASA anti-inflammatory drugs such as Asacol®, Azulfidine®, Colazol®, and Pentasa®
  
• Steroids, such as prednisone, prednisolone, or budesonide immunodulators such as Imuran® (azathioprine), Purinethol®(6MP), and for Crohn’s disease methotrexate
  • Biologicals, such as Remicade®, Humira®

DIET AND NUTRITIONAL THERAPIES
Good nutrition plays an important role in managing and overcoming IBD. Ulcerative colitis and Crohn’s disease can pose nutritional challenges for children. Usually, there are no major restrictions on the diet of a child with IBD. However, you should monitor your child’s diet and watch for any sensitivities to certain foods. Some situations may necessitate a change to your child’s diet.

SURGERY
Because there is a high risk of recurrence after surgery in Crohns disease, this option is reserved for complications such as an obstruction from a narrowed area of the intestine, chronic pain, bleeding, or when using all other medicine does not work. The cure for ulcerative colitis is the complete removal of the large intestine. This is called a total colectomy. It is possible in most patients to reconnect the small intestine to the anus, so that there is no need to wear a permanent bag (ostomy), although a temporary ostomy is generally needed. This second operation is called an ileo-anal pull through, and is expected to offer continence and normal defecation.

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RESEARCH
Our center puts a strong emphasis on research as a tool to provide excellent care to your child. We are involved in national studies and private organizations.

We closely work with CCFA both local and nationally. Our center also participates in an International IBD research data base which is being used in the ongoing effort to improve the treatment and quality of life for all those with IBD.

For more information, go to www.improvecarenow.org
Improve Care Now is an alliance of health care professionals and patients that has developed a Model IBD Care Guideline based on the carefully analyzed results of thousands of doctor–patient visits as well as the latest studies and treatments from around the world.

GASTROENTEROLOGY CENTER

GASTROENTEROLOGY CLINIC:

Monday - Friday
Contact: 510-428-3058

IBD DEDICATED-MULTIDISCIPLINARY CLINIC:
1 day per month, 8 AM - 12 Noon (for appointment schedules call 510-428-3058)

If your child has been diagnosed with IBD, and you would like to schedule an appointment, please contact the clinic at 510-428-3058 and advise the schedulers of your child’s condition.

CARE TEAM

• Elizabeth Gleghorn, MD
  
• Sabina Ali, MD
  
• Mala Setty, MD
  
• Judy Fuentebella, MD
  
• Paul Harmatz, MD
  
• Ellen James, PhD, PNP
  
• Erin Stege, PNP
  
• Daine Valmossi, FNP
  
• Lynn Esparaza, PNP
  
• Jacqueline Madden, PNP – Clinical Research Coordinator
  
• Ellen Fung, PhD, RD – Bone Health and IBD
  
• Gail Seche, RD, CSP
  
• Linda Sugmimura, RD, CSP
  
• Darby Schouten, LCSW (Clinical Social Worker)

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