Crohn's disease in children and teens

Crohn's disease is a chronic or long-term disease. In Crohn's disease, the intestines become inflamed and ulcerated or scarred with ulcers. Along with ulcerative colitis, Crohn's disease belongs to a group of diseases known as inflammatory bowel disease.

Crohn's disease usually affects the lower part of the small intestine, called the ileum. However, it can occur anywhere in the large or small intestine, stomach, or esophagus. It can even happen in the mouth. Crohn's disease can occur at any age. However, it most often occurs in people between the ages of 15 and 30. Children and teens with Crohn's disease face unique challenges. Crohn's disease can stun growth, weaken bones, and delay puberty

How does Crohn's disease affect the gut?

Crohn's disease can disrupt normal bowel function in several ways. Intestinal tissue can cause:

Swelling, thickening, or narrowing (scar tissue) that causes an obstruction (blockage) in the passage within the intestines
Development of ulcers in the deeper layers of the intestinal wall
Loses the ability to absorb nutrients from digested food (malabsorption), especially in the ileum where vitamin B12 and bile acids are absorbed.
Development of abnormal passages (fistulas) from one part of the intestine to another or from the intestine to nearby tissues

What are the symptoms of Crohn's disease in children and teens?

The symptoms of Crohn's disease depend on where in the gut the disease occurs. They also depend on its severity. In general, symptoms may include:

Chronic diarrhea with or without blood in the stool
Rectal bleeding
Weight loss
Fever
Abdominal tenderness
Feeling of mass or fullness in the lower right abdomen
Fatigue

In children and teens with Crohn's disease, periods of severe symptoms alternate with periods without symptoms. The asymptomatic period is called remission and can last weeks or years. Anti-inflammatory drugs or dietary changes can induce remission, but there is no way to know when remission will occur or when symptoms will return.

Other symptoms may develop depending on the complications of the disease. For example, a person with a fistula—an abnormal passage—in the rectal area may have pain and discharge around the rectum. Other complications of Crohn's disease include:

Arthritis
Gallstones
Kidney stones
Inflammation (swelling) of the eyes and mouth
Liver disease
Skin rashes or ulcers
Anemia

What causes Crohn's disease in children and teens?

The cause of Crohn's disease is unknown. It is likely that Crohn's disease is an inherited disorder that causes an abnormal immune system response in the gastrointestinal tract.

People who have parents with Crohn's disease are more likely to develop the disease themselves. People of Jewish origin also have a greater risk of contracting the disease. However, the risk of contracting Crohn's disease is low.

How is Crohn's disease diagnosed?

The doctor will review the patient's medical and family history. Various tests are used to diagnose Crohn's disease, including the following:

Endoscopy: During this procedure, the doctor inserts a flexible lighted tube with a camera into the rectum. The tube and camera together are called an endoscope. Used to examine the rectum and colon. Colonoscopy shows more of the colon than sigmoidoscopy. A small sample of tissue may be taken for analysis or biopsy.
Blood tests: During a blood test, the doctor will look for signs of anemia or a high white blood cell count. A high white blood cell count indicates inflammation or infection somewhere in the body. The doctor will also run tests to look for and identify inflammatory markers.
Barium x-rays (barium enema or small bowel series): These procedures use x-rays to look at the upper or lower intestines. Barium coats the lining of the small and large intestines and appears white on x-ray. This allows the doctor to consider any abnormalities.

How to treat Crohn's disease in children and teens?

Treatment for Crohn's disease depends on its severity and location. The disease can sometimes go into remission on its own. Therefore, it is not always possible to determine whether a particular treatment has been effective. When Crohn's disease is active, treatment focuses on controlling inflammation, correcting nutritional deficiencies, and relieving symptoms such as pain, diarrhea, and fever.

In general, drugs are the first step in treating Crohn's disease in children and teens. Some of these medications include anti-inflammatory drugs, antibiotics, antidiarrheals, and immunosuppressants (including corticosteroids).

Medicines called biologics are also used to treat Crohn's disease. They are called biologics because the drugs are made from proteins found in the human body's immune system. The proteins are genetically modified and transformed for use as a treatment. Biological drugs, which are administered by intravenous injection or infusion, are designed to suppress the inflammatory processes characteristic of Crohn's disease.

Supplements are often prescribed for nutritionally deficient patients. There are also studies on diet modification, including an all-liquid diet.

Sometimes medications do not control Crohn's disease. In these cases, surgery is sometimes necessary to remove part of the intestine. The disease, however, often returns to the area near the site where the inflamed part was removed.

A healthy lifestyle plays an important role in the treatment of Crohn's disease. Children and teenagers should exercise regularly and eat right. People with this condition can usually lead a healthy and active lifestyle. Most children with Crohn's disease can attend school and participate in sports and daily activities if the disease is treated and managed properly.