By Dr. Nidhi Rawal
Inflammatory Bowel Disease (IBD) is a condition where there is inflammation (swelling) and ulcers in the intestines, which results in poor absorption of nutrients and hence poor growth. It is a chronic condition, which means it can last a long time or come and go.
Children with IBD continue to have abdominal pain and diarrhoea (loose stools) and do not respond to usual medical treatments. They can also have poor energy levels, weight loss, blood in the stools, mouth ulcers, eye pain, rashes on their skin, swelling and pain in the joints. If treatment is not started at the right time, it can also cause delays in puberty, poor height as an adult, or menstrual irregularities.
Three in 100 children are diagnosed with IBD. Approximately 25% IBD cases are in those under 18 years of age. This condition is becoming more common in children and better awareness helps us to diagnose this condition at the right time and prevent complications.
There are many theories about how a person gets IBD, but nothing conclusive has been found. It is an autoimmune condition, where your own immune system is acting against your own intestines. Both genes and environment have been shown to play a role. IBD may be triggered by an infection but it is not contagious.
There are two types of IBD:
Crohn’s disease: In this condition, all layers of the intestines can be involved and ulcers can develop in any part of the digestive system from mouth to anus.
Ulcerative colitis: In this condition, mostly the colon is involved and children usually present with blood in stools.
A diagnosis of IBD is like putting a puzzle together. It involves blood tests, stools tests, and CT/MRI scans. Final diagnosis is achieved by Upper GI endoscopy and Colonoscopy.
In Upper GI endoscopy, an expert gastroenterologist examines the upper digestive system by introducing a small camera through the mouth.
In Colonoscopy, a similar examination is done for the lower digestive system by introducing a camera through the anus.
Endoscopy is a relatively safe procedure, with minimal risks and complications. Both Upper GI endoscopy and Colonoscopy can be performed on an out-patient basis, under mild short-lasting sedation, which makes this procedure completely painless for the child. Children can usually resume a normal diet right after the procedure and are discharged the same day.
There are many medical treatments available for IBD. Choice of medication depends on the severity of the disease. Diet plays a very important role in managing IBD. Surgery might be needed if there is a blockage of the intestines or a hole in the bowel or persistent bleeding.
With the advanced medical treatments available, our goal is always to maximise the child’s daily quality of life. We have been able to achieve this by establishing healthy dietary patterns, optimising medical treatments, consistent patient and family education about IBD, and establishing support groups for children with IBD.
This article was published in association with Rainbow Children’s Hospital.