What is inflammatory bowel disease (IBD)?

Related links:

• Our services: Caring for children with inflammatory bowel disea

Related tests and treatments:

• Biopsy
• Endoscopy
• Stool test
• Infusion
• Enteral nutrition
• Magnetic resonance enterography (MRE)
• Surgery

About inflammatory bowel disease

Inflammatory bowel disease is the broad term for a condition that causes inflammation in the intestinal tract. The two most common diagnoses within IBD are Crohn’s disease and ulcerative colitis.

What causes inflammatory bowel disease?

The causes are not well understood, though researchers are studying the role of genetic predisposition, environmental factors and dietary factors. Doctors think that IBD is an autoimmune condition, which means that patients with IBD might have an overactive immune system that mistakes normal contents of the GI tract as foreign, causing chronic inflammation.

How often does inflammatory bowel disease occur?

IBD is relatively common and affects 1 in 200 Americans, according to the Crohn’s & Colitis Foundation of America. Crohn’s disease is more common than ulcerative colitis. Most patients are between 15 to 30 when the disease begins, though it can occur at any age.

What are the symptoms of inflammatory bowel disease?

Symptoms vary but typically include:

• Abdominal pain
• Diarrhea
• Blood in stool
• Weight loss
• Delayed growth/delayed puberty

Who is at risk of developing this condition?

Researchers do not fully understand the causes of this disease to determine the risk factors. But if you have a family member with IBD or other autoimmune conditions, you might have a slightly higher risk of developing IBD.

Why is inflammatory bowel disease a concern?

Chronic inflammation can have serious consequences if it’s not diagnosed and treated. Children who have undiagnosed Crohn’s disease could develop severe intestinal infections and narrowing of the intestines, increasing the likelihood of surgery. In extreme cases, the intestines might get so narrow that food can’t pass through. Patients with Crohn’s are also at risk for fistulas, which are abnormal connections of the GI tract. A child’s growth can be compromised because the body can’t absorb nutrients and is devoting its energy to fighting the inflammation. Children with Crohn’s might also have poor appetite.

Children with ulcerative colitis can experience frequent diarrhea and rectal bleeding, and if the condition goes untreated, children might require surgery to remove the colon. Untreated IBD also puts patients at risk for colon cancer.

How is inflammatory bowel disease diagnosed/evaluated?

If your child’s doctor suspects IBD based on your child’s symptoms, then he or she will use endoscopy to confirm the diagnosis. A biopsy of intestinal tissue will look for signs of inflammation. The doctors may also use bloodwork and stool tests to check for the presence of blood and to make sure there’s no other infectious cause for the inflammation.

What is the treatment for inflammatory bowel disease?

Treatment for IBD depends on the extent and severity of the specific condition, but it usually involves controlling inflammation with oral medications. Although there’s no cure for IBD, doctors can usually induce remission of the disease with dietary changes and anti-inflammatory medications like steroids. Once a patient is in remission, the doctor might prescribe other medications to keep the inflammation under control.

Another possible treatment are infusions, where doctors infuse medications, including antibodies, that target a very specific part of the immune system. Your child’s doctor might also suggest trying a period of exclusive enteral nutrition, in which your child receives all nourishment via hypoallergenic liquid supplements instead of solid food. This sometimes requires the use of tube feeding. This treatment can help induce remission in some patients.

What happens after treatment?

Most children do very well once their IBD is in remission. Their symptoms resolve, they have better growth and formed stools, and they lead active, normal lives. A small percentage of patients won’t respond to initial treatments and may need surgery to relieve chronic symptoms. Patients will still need medication and dietary changes even after their IBD is in remission, and they usually also require periodic blood work or infusions.

When should you contact a physician?

Talk to your pediatrician if your child is experiencing symptoms such as prolonged diarrhea, blood in the stool, chronic abdominal pain, persistent fever and poor growth. If necessary, your pediatrician may refer you to a pediatric GI specialist.

What is the long-term outlook for inflammatory bowel disease?

There is no cure for IBD, but children should be able to resume a normal quality of life once the disease is in remission.

How do I live with inflammatory bowel disease?

IBD is a lifelong condition that is controllable with the right balance of medication and diet changes. Symptoms are likely to return if a child stops treatment.

For more information about IBD, visit the Crohn’s and Colitis Foundation of America.