Understanding Inflammatory Bowel Disease
What Is Inflammatory Bowel Disease
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:
- Crohn’s disease (CD)
- 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.
- 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
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
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
- IBD affects around 1.4 million Americans, including around 80,000–100,000 children and young
- While many people confuse IBD with IBS (irritable bowel syndrome), they are very different conditions.
Crohn's Disease And Ulcerative Colitis
Crohn’s disease can involve any part of the gastrointestinal tract, from the mouth to the anus.
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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Treatments For Crohn's Disease And Ulcerative Colitis
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.
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
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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 Consultations & Appointments
Children's Gastroenterology Clinic:
Hours: Monday - Friday
IBD Dedicated-Multidisciplinary Clinic:
Hours: 1 day per month, 8 AM - 12 Noon
If your child has been diagnosed with IBD, and you would like to schedule an appointment, please contact
the clinic and advise the schedulers of your child’s condition.
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