Pediatric Crohn's disease

What is pediatric Crohn's disease?

Pediatric Crohn’s disease is a long-term (chronic) condition that causes redness or swelling (inflammation) in any area of the gastrointestinal tract. This includes the mouth, esophagus, stomach, intestines, and rectum. For many children, the small intestine is the most affected area.

Crohn’s disease is a form of inflammatory bowel disease (IBD). It’s usually diagnosed between the ages of 15 to 20 but it can happen at any age.

Crohn's disease was first described by Dr. Burrill Bernard Crohn in 1932 with his colleagues Dr. Leon Ginzburg and Dr. Gordon Oppenheimer in New York.

What are the different types of pediatric Crohn's disease?

There are five types of Crohn’s disease including:

1. Jejunoileitis - Affects the middle part of the small intestine (jejunum).

2. Ileitis - Affects the final section of the small intestine (ileum).

3. Ileocolitis - Affects the end of the small intestine (ileum) and the first part of the large intestine (colon).

4. Gastroduodenal Crohn’s - Affects the stomach and first section of the small intestine (duodenum).

5. Granulomatous colitis or Crohn’s colitis - Affects only the colon.

What are the signs and symptoms of pediatric Crohn's disease?

• Abdominal pain

• Diarrhea

• Constipation

• Rectal bleeding

• Weight loss

• Delayed growth

• Low energy or fatigue

Crohn’s disease can also cause other complications, including:

• A cut or tear in the anus (anal fissure)

• A blockage or narrowing in the intestines

• Gallstones

• Low blood count (anemia)

• Bone weakness (osteoporosis)

• Eye redness or swelling

• Skin problems

Symptoms of Crohn’s disease can range from mild to severe. They can also come and go, sometimes disappearing for years (remission) then flaring up again. While there isn’t a way of knowing when remission will happen or when symptoms will return, we can help manage your child’s condition at every stage of their life.

How is pediatric Crohn's disease diagnosed?

At Children’s Health, we use state-of-the-art tests and procedures to diagnose children and young adults with Crohn’s disease.

These include:

• Blood test - This counts the red and white blood cells to check for blood loss, inflammation and infection.

• Stool study -This checks your child’s stool for blood, infection and signs of inflammation.

• Upper endoscopy (EGD) - This allows us to look inside the esophagus, stomach, and beginning section of the small intestine.

• Colonoscopy - This allows us to see inside the large intestine and the last part of the small intestine (ilem) to check for inflammation, bleeding and sores.

• Capsule endoscopy - This test uses a tiny camera or capsule to take detailed pictures of the inside of the small intestine.

• Magnetic resonance enterography (MRE) - This is an imaging test that takes pictures of the small intestine to catch signs of inflammation.

What causes pediatric Crohn's disease?

The exact cause of Crohn’s disease isn’t known but we do know.

Possible triggers include:

• Having a family history of inflammatory bowel disease (IBD)

• Eating a diet that is low in fiber and high in fat

• Taking certain medications, like ibuprofen, naproxen and antibiotics can irritate the digestive tract

How is pediatric Crohn's disease treated?

Crohn’s disease is a long-term disorder. Our goal with treatment is to help control your child’s symptoms. This is done by creating a plan that reduces inflammation, eases symptoms, and prevents potential complications, like intestinal blockage or tears.

Depending on the severity of your child’s condition, their treatment may include the following:

• Medication - The most common medications we prescribe include steroids, immunosuppressants and biologics to reduce inflammation.

• Diet and supplements - This involves adjusting your child’s diet and including vitamin supplements so they can get the nourishment they need to stay healthy.

• Surgery - This involves removing the inflamed section of the intestines. Surgery is usually recommended when a tear or blockage occurs.