Help your child control inflammatory bowel disease (IBD)

December 13, 2023

Providence Children's Health Team

[5 MIN READ]

Inflammatory bowel disease (IBD) is different from irritable bowel syndrome (IBS) in that it causes chronic inflammation, leading to multiple symptoms.
There are two main types of inflammatory bowel disease — Crohn’s disease and ulcerative colitis.
Treatment for inflammatory bowel disease can include nutritional therapy, medications or surgery.

As modern medicine continues to evolve, researchers find new and more effective ways to treat many kinds of diseases. Inflammatory bowel disease (IBD) is one of the conditions that has benefitted the most from new treatments in recent years. Now, if you have a child or teenager with the condition, you have many options to help them manage it.

Here at Providence, doctors are at the cutting edge of new research and treatments for IBD.

What is inflammatory bowel disease (IBD)?

IBD refers to two chronic gastrointestinal conditions — ulcerative colitis and Crohn’s disease.

Crohn’s disease causes part of the intestine to become red and swollen. It can occur in any part of the gastrointestinal tract, from the mouth to the anus.
Ulcerative colitis is also an inflammatory condition that causes sores called ulcers in the large intestine.

Some people confuse IBD with irritable bowel syndrome (IBS), another gastrointestinal condition that can affect both children and adults. IBS is a chronic disorder that causes cramping, diarrhea, abdominal pain, bloating, gas and constipation.

“The major difference between irritable bowel syndrome and inflammatory bowel disease is that IBD causes chronic inflammation,” said Matthew Riley, M.D., clinical director of pediatric gastroenterology for the Providence Oregon region. “If left untreated, IBD can cause permanent damage to the intestine and colon, including blockages, narrowings and even holes in the intestinal wall. While IBS causes chronic and unwanted symptoms, it does not cause damage to the gastrointestinal tract.”

Symptoms of IBD

The most common symptoms of Crohn’s disease are belly pain and diarrhea, but other symptoms can include:

Weight loss
Lack of energy
Blood in the stool
Fever
Nausea and vomiting
Skin tags, sores or drainage around the anus

Crohn’s disease can also lead to other problems such as poor growth, joint pain, rashes or eye problems.

Ulcerative colitis has most of the same symptoms (and can cause most of the same additional problems) as Crohn’s disease, except that children and teens with ulcerative colitis may also feel an urgent need to poop.

Of course, there are many different gastrointestinal diseases that have similar symptoms. “My birthday wish every year is for X-ray vision, so I could just look right inside my patients and know exactly what is going on,” Dr. Riley said. “Until then, we have to rely on listening to a child’s story and thoughtful use of medical tests. Most conditions can be ruled out with a comprehensive set of blood and stool tests. If those initial tests show clues to a serious medical condition, we may need to use X-ray, ultrasound or even endoscopy to find out what the problem is.”

Complications of IBD

While IBD can occur at any age, it is very rare in children younger than 5. Most cases in children and young adults start between ages 12 and 21, and the symptoms can continue for a lifetime.

If a child with IBD does not receive treatment, the symptoms of both Crohn’s disease and ulcerative colitis can be quite severe. That might mean your child has to miss out on regular activities or even stay in the hospital.

Walled-off infections, called abscesses, can occur in Crohn’s disease, as well as narrowings, blockages and holes in the intestine. These symptoms may require medical procedures or surgeries to manage them. For some patients, ulcerative colitis can still lead to surgical removal of the colon.

Treatment for IBD

There is no one-size-fits-all treatment for the two types of IBD. Depending on your child’s individual symptoms, your child’s doctor may recommend:

Nutritional therapy – Providence dietitians will work with your child to find a nutritional program that reduces inflammation.
Medications – Children respond to different medications — and sometimes a combination of medications — in different ways.
Surgery – For situations in which other therapies are not working, surgeries might be the best option. These can include removing damaged parts of the intestine, as well as surgical removal of the colon.

However, there’s reason for hope.

“New medications to treat IBD are being approved nearly every year now, which is incredibly exciting,” Dr. Riley said. “We are learning more about the role of nutrition in controlling IBD. Compared to when I started practicing pediatric gastroenterology nearly 20 years ago, we can find safe and effective treatment options for the large majority of our patients. So, with time, patience and a great relationship with your medical team, we expect things to only get better and better over time for most of our patients these days.”

Contributing caregiver

Matthew Riley, M.D., is the clinical director of pediatric gastroenterology for the Providence Oregon region.

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