Crohn's Disease

Children with Crohn’s disease may have delays in growth and sexual maturation. Evaluating a delay in growth is often a first step in discovering that a child has this disease.

Symptoms of Crohn’s disease vary from one child to another and may include:

• Abdominal (belly) pain and cramping, bloating
• Diarrhea, blood in stool
• Rectal pain, bleeding from the rectum
• Decreased appetite and weight loss
• Mouth ulcers
• Fever
• Skin rashes
• Tiredness
• Eye redness
• Constipation
• Joint pain
• Rectal pain

Symptoms may come and go. Your child may have long periods with no symptoms at all. This is called remission. When symptoms return or increase in severity, this is called exacerbation.

See a doctor if your child has:

• Continued changes in bowel movements
• Severe abdominal or rectal pain
• Blood in the stool
• Ongoing diarrhea that doesn’t respond to over-the-counter medicines
• Weight loss
• Fever

Doctor’s don’t know exactly what causes Crohn’s disease. But they do know that certain things give people a greater chance of getting it. These include:

• Age. Most people first get it between the ages of 20 and 30 years. But, a person can get it at any age — even in childhood.
• Family history. About 1 in 5 people with Crohn’s disease have a parent, brother, or sister with the same disease.
• Race or ethnicity. White people have a greater chance of getting Crohn’s disease than people of other races. Also, people of Ashkenazi Jewish descent have a greater chance of getting the disease.
• Where your child lives. Your child has a greater chance of getting Crohn’s disease if they live in a city, in a developed country, and in a northern climate.
• Certain medicines, such as steroids. Isotretinoin (Accutane) is a steroid medicine used to treat acne. Some studies show children who use it are more likely to get Crohn’s disease.
• Smoking. Smoking will make your child’s Crohn’s disease more serious and make them more likely to need surgery.

Your child’s doctor may use a few tests to find out if they have Crohn’s disease. These may include:

• Blood tests to check for anemia and make sure their cells are getting enough oxygen.
• A stool sample test to see if there is bleeding or infection in their intestines.
• A colonoscopy so the doctor can look at the inside of their intestines and see if the tissue is inflamed (swollen). The doctor can also take a tissue sample (biopsy) to send to a laboratory for testing.

Doctors can treat the symptoms of Crohn’s disease, but there is no known cure for it. Treatments can reduce inflammation and relieve other symptoms such as diarrhea and bleeding. Treatment can sometimes stop your child’s symptoms for long periods of time. Treatments may include:

• Medicines. Most people are treated with medicines to reduce inflammation. Some children may also be treated with medicines that keep the immune system from attacking the digestive tract. Other medicines may be used to treat infections or diarrhea.
• Food and nutrition. Your child’s doctor may recommend special nutrition supplements for a short time. If your child’s digestive system needs to rest, they may be given nutrition through a feeding tube or directly into a vein. Your child’s doctor may also recommend changing their diet. This might include:
• Eating a high-calorie, high-protein diet to prevent malnutrition and weight loss. Specific food choices don’t appear to make most symptoms better.
• Avoiding whole grains, spices, and milk products when your child has diarrhea and cramping.
• Certain vitamin and mineral supplements, as recommended by your child’s doctor or dietitian.
• Surgery. If medicines don’t control your child’s symptoms, your child may need surgery. About 2 out of every 3 patients with Crohn’s disease will need surgery at some point. Crohn’s disease can still come back after surgery, however. Different types of surgeries include:
• Bowel resection, which removes a diseased part of the large intestine (colon).
• Colectomy, which removes the entire colon.
• Other surgeries, which can be done to correct problems in the intestines like blockages, tears, areas full of pus, or bleeding.

There is no known way to prevent Crohn’s disease. However, the goal of treatment – in addition to improving symptoms – is to prevent other health problems and prevent future flare-ups. Flare-ups may be prevented by taking medicines to keep the immune system from attacking the digestive tract.

Crohn’s & Colitis Foundation:
Treating Children and Adolescents
Crohn’s Disease & Ulcerative Colitis: A Guide for Parents

KidsHealth:
Crohn’s Disease

Crohn’s [KROHNZ] disease is an autoimmune disease of the digestive tract. Your child’s immune system should protect their body from sicknesses. But in Crohn’s disease, their immune system attacks the digestive tract by mistake.

Crohn’s disease causes patches of inflammation (swelling) that can affect any part of the digestive tract, from the mouth to the anus. It most often affects the lower part of the small intestine. The swelling spreads deep into the lining of the tissue.

Crohn’s disease is a chronic (lifelong) condition. Symptoms can be treated, and may stop for periods of time. Periods without symptoms are called remission. Children with Crohn’s disease can live a normal, productive life.