Abdominal Pain and Pediatric IBD
Inflammatory bowel disease can be embarrassing and painful, and have major health consequences for your child.
As a pediatric gastroenterologist, I see a wide variety of conditions that challenge our young patients and their families. We often see children and adolescents who struggle with abdominal pain, sometimes for months on end, with acute episodes that land them in the hospital. These parents remark, “She has always had gastrointestinal problems, but until now they’ve resolved on their own.” These are the times it’s worth getting a referral to investigate an inflammatory bowel disease diagnosis and determine a treatment plan to provide the best care for your child.
What is Inflammatory Bowel Disease (IBD)?
IBD is a chronic, autoimmune condition that causes inflammation throughout the gastrointestinal tract. The group of disorders includes the diagnoses of Crohn’s disease, ulcerative colitis (UC) and indeterminate colitis (IC). Twenty-five percent of patients with IBD present during childhood/adolescence and patients diagnosed earlier in life tend to have a more severe disease.
What causes IBD?
The exact cause of IBD is unknown, but there are genetic and environmental factors that contribute to its development. Research to delineate the exact genetic markers is ongoing. There is also continuing evaluation of the role of diet and antibiotics in development of these disorders.
What symptoms does IBD cause?
Typical symptoms of IBD include abdominal pain, diarrhea, blood in the stool and weight loss. Patients may also have vomiting, fever, growth issues and fatigue. Patients sometimes have extraintestinal manifestations of IBD. This can affect nearly any body system but the most common include joint pains or swelling, rashes and vision abnormalities.
Symptoms of IBD overlap with many other conditions. Sometimes patients have symptoms for a very short period, but other times the symptoms come and go for quite a while.
How is IBD diagnosed?
Laboratory testing is often quite helpful and may show anemia (low blood counts) and elevated markers of inflammation in the blood or stool. The official diagnosis of IBD requires endoscopies (EGD, colonoscopy and capsule endoscopy). Sometimes a special type of MRI or CT scan is also needed for diagnosis.
How is IBD treated?
Inflammatory Bowel Disease is a chronic illness for which there is no cure. Thankfully, many patients achieve remission with the use of medication, of which there are many. There is a significant amount of research being done and many new medications are being approved which is great news! All of the medications that are used aim to decrease inflammation. There are also diet options for those with a mild disease. Sometimes, surgical intervention is also necessary. The goal of treatment is to make the patient feel well and to heal any inflammation that is present.
A multidisciplinary approach to patients with IBD is important, as this disease affects our pediatric patients and their families immensely. Dieticians, social workers, psychologists, nurses and physicians work closely to ensure all aspects of our patients’ wellbeing.
Where can I learn more about IBD?
The Improve Care Now Network is a quality improvement database network connecting 110 Pediatric IBD centers across the world. The research and clinical information derived from the network has doubled the rates of remission for pediatric patients with IBD since its inception in 2006.
The Crohn’s and Colitis Foundation of America also has excellent resources for patients and families. There is a local chapter that has an annual walk and education day, in addition to many other activities for families to participate in each year.
Dr. Tiffany Linville is a board-certified pediatrician and pediatric gastroenterologist. She completed her general pediatric residency and later pediatric gastroenterology fellowship at the University of Florida. Dr. Linville is currently the director of the Pediatric Inflammatory Bowel Disease Program at Atrium Health’s Levine Children's Hospital.