Inflammatory Bowel Disease in Children and Adolescents
Posted On Jun 25, 2020
4 Min Read
Dr. Srikanth K P
Consultant - Paediatric Gastroenterology And Hepatology
Manipal Hospital - Sarjapur Road
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What Is Inflammatory Bowel Disease?
Inflammatory Bowel Disease (IBD) is a chronic condition common in children. It has been estimated that almost 25% of all cases of IBD occur in children. Two types of IBD are Ulcerative colitis and Crohn's disease. Both types of IBD have specific characteristics and have different treatment regimens. However, when the clinical features fail to distinguish between the two types, the condition is termed indeterminate colitis. IBD is characterized by inflammation and swelling in the lower part of the gastrointestinal tract i.e. the colon and rectum. Pediatric IBD is a complex condition and the incidence of IBD in the pediatric population is on the rise. Extraintestinal symptoms of IBD occur in approximately 25-35% of the patients. However, in children, the extraintestinal symptoms may occur much before the gastrointestinal symptoms while in adults these symptoms occur simultaneously with gastrointestinal symptoms.
What Is the Pediatric Inflammatory Bowel Disease Program?
The pediatric inflammatory bowel disease program is a specialized program for children suffering from IBD. The program offers comprehensive diagnosis and management of IBD including ulcerative colitis and Crohn’s disease along with other intestinal disorders. Hospitals with large infrastructures have a multidisciplinary approach and a team of specialists including gastroenterologists, urologists, paediatricians, and nutritionists provide excellent care to the patients. Along with medications and surgical interventions, diet care, stress management, and lifestyle changes are also advised under the Pediatric inflammatory bowel disease program.
What Are the Symptoms of Inflammatory Bowel Disease?
The symptoms of IBD depend upon the type developed in children.
General symptoms of IBD are:
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Weight loss
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Fever
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Delayed growth
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Diarrhea
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Fatigue
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Blood in stools
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Reduces appetite
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Iron deficiency anaemia because of blood loss
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The urgency for a bowel movement
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Inflammation in skin, joints, and eyes
What Are the Risk Factors for Inflammatory Bowel Disease?
Factors that exacerbate or increase the risk of developing IBD are:
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Family History
The risk of developing IBD increases when a close relative of the person such as parents or child suffers from IBD.
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Age
Generally, IBD is diagnosed in people under the age of 30 years. However, it may also be diagnosed after 50 years.
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Ethnicity
White people have a high risk of developing this condition.
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Smoking
People who smoke are at increased risk of developing and exacerbating IBD.
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Habitat
Environmental factors such as smoke or pollution also increase the risk of IBD.
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Prolonged use of Anti-inflammatory medications
NSAID drugs increase the risk of developing IBD and worsen the symptoms of this condition.
What Are the Types of Inflammatory Bowel Disease?
The two types of IBD are Crohn’s disease and Ulcerative colitis. It is important to diagnose the type of IBD because both have different medical intervention strategies.
Characteristics |
Crohn’s Disease |
Ulcerative Colitis |
|
Affected site |
May affect any part of GIT |
Affects the colon in most cases |
|
Abdominal Pain |
Common |
Unusual |
|
Distribution |
Discontinuous |
Continuous |
|
Fever and malaise |
Common |
Uncommon |
|
Colon cancer risk |
Slightly increased |
Significantly increased |
How is the Diagnosis of Inflammatory Bowel Disease Done?
The diagnosis of IBD is done through the following diagnostic techniques:
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Physical Examination
A comprehensive physical evaluation is done by the top gastroenterologist in Bangalore on patients who are presented with the symptoms of IBD such as abdominal pain, fever, and diarrhoea. The doctor may advise further tests to confirm the diagnosis of IBD.
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Blood tests
Blood tests help in providing important clues related to inflammatory bowel disease. Anaemia and the presence of infection are determined through blood tests.
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Stool test
The stool test is done to identify the presence of blood in stools.
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Endoscopic procedures
Various endoscopic procedures are done to determine the presence, extent, and severity of the disease. Various endoscopic procedures done are colonoscopy, upper endoscopy, flexible sigmoidoscopy, balloon-assisted endoscopy, and capsule endoscopy.
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Imaging tests
Imaging tests such as X-rays, MRI, and CT scans are also performed to diagnose IBD.
What Are the Treatment Options for Inflammatory Bowel Disease?
The treatment for IBD depends upon the type of condition, i.e. whether ulcerative colitis or Crohn's disease. The treatment aims to prolong the period of remission and prevent the occurrence of inflammation and pain. Following are some of the treatment options available at the best pediatric hospital in Bangalore for IBD:
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Medications
Various medications are prescribed for IBD. Corticosteroids and other anti-inflammatory drugs are administered to reduce inflammation. Immunosuppressants are prescribed to keep the immune system under check. Other medications include antibiotics, pain relievers, vitamins, and mineral supplements.
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Nutrition
Nutritional support is provided to the patient suffering from IBD. This may include specialized diet protocols such as Crohn's Disease Exclusion Diet (CDED) and Exclusive Enteral Nutrition (EEN), which do not irritate the GIT and enteral tube feeding or parenteral nutrition.
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Surgery
As ulcerative colitis is generally specific to the colon, removing the colon and rectum (proctocolectomy) may cure this condition. However, Crohn’s disease, although requiring surgery, cannot be cured. The surgery for Crohn’s disease only offers temporary relief.
