Crohn's disease is when there is redness, swelling (inflammation), and sores along the digestive tract. It is part of a group of diseases known as inflammatory bowel disease or IBD.
Crohn’s disease is a long-term (chronic) condition. It may come and go at different times in your child’s life. In most cases it affects the small intestine, most often the lower part called the ileum. In some cases, both the small and large intestines are affected.
Sometimes the inflammation may affect the whole digestive tract. This includes the mouth, the food pipe (esophagus), the stomach, the first part of the small intestine (duodenum), the appendix, and the anus.
Experts don’t know what causes Crohn's disease. It may be that a virus or bacteria affects the body's infection-fighting system (immune system). The immune system may have an abnormal inflammation reaction in the intestinal wall that doesn’t stop.
Many children with Crohn’s disease have an abnormal immune system. But experts don’t know if immune problems cause the disease. They also don’t know if Crohn’s disease may cause immune problems.
Crohn's disease may happen at any age. It most often affects people ages 15 to 35. But Crohn's may also occur in young children. It affects both males and females equally.
Children or teens may be more at risk for Crohn’s disease if they:
Each child’s symptoms may vary. Symptoms may include:
Some children may have no symptoms for a long time, even years. This is called being in remission. There is no way to know when remission may occur or when your child’s symptoms will return.
The symptoms of Crohn's disease may look like other health problems. Always see your child's healthcare provider for a diagnosis.
Your child may be checked for signs of Crohn's disease if he or she has had long-term:
Your child’s healthcare provider will take a health history and do a physical exam. Other tests for Crohn's disease may include:
Crohn’s disease is a long-term (chronic) disease. There is no cure for it. But there are some things that can help to control it. Treatment for the disorder has 4 goals:
Your child’s healthcare provider will create a care plan based on:
Your child’s treatment may include the following.
Medicines often reduce the inflammation in the colon. This may help ease belly cramps and diarrhea. More serious cases may require steroids, antibiotics, or medicines that affect the body's immune system.
Making some changes in your child’s diet may help to ease symptoms. In some cases, symptoms are made worse by milk, hot spices, or fiber. Talk with your child’s provider. In some cases, your child may use a special meal plan called an elemental diet.
Vitamins may help prevent some problems or help maintain a remission. Because many children with Crohn's don't absorb nutrients normally, vitamin deficiencies are common. Your child may need lab tests to assess the nutrient levels. Talk with your child’s provider about any vitamin supplements. These treatments have risks and may cause harmful side effects.
Your child’s provider may suggest nutritional supplements or special high-calorie liquid formulas. These may be helpful if your child has delayed growth.
In rare cases IV feeding may be used for children who need extra nutrition for a short time.
Surgery may help Crohn’s disease, but it can’t cure it. Surgery may help to reduce long-term symptoms that don’t get better with medicine. Surgery may also fix some problems. These include a blocked intestine, a hole or perforation, a sore or abscess, or bleeding. Types of surgery may include:
Children with Crohn’s disease may lose weight because they don’t get enough calories. This can happen because a child:
Nutritional supplements or special high-calorie liquid formulas may be suggested. This is often recommended if a child has delayed growth.
Crohn’s disease may also cause other health problems such as:
After bowel resection surgery, a condition called short bowel syndrome can occur. It often happens after a large part of the small intestine is removed. The body then may not be able to digest and absorb some vitamins, foods, and nutrients, including water. This poor absorption of food and nutrients is called malabsorption. It causes diarrhea. It can also lead to poor growth and development. Common symptoms of malabsorption include:
Crohn's disease is a long-term (chronic) condition. It may come and go at different times during your child’s life. Children may have physical, emotional, social, and family problems as a result of the disease. It’s important to work closely with your child’s healthcare provider to manage and treat the condition.
Be sure to have the provider check your child’s health on a regular basis. This includes checking your child's:
No special diet has been shown to treat Crohn’s disease. Many children with the disorder can eat a fairly normal diet when their disease is stable. Talk with your child’s healthcare provider. When your child is having symptoms, it may be helpful to follow these suggestions:
Avoid foods that produce more gas, such as:
Add foods that have more soluble fiber. This is fiber that absorbs water. Foods that are good sources of soluble fiber include:
Children who have short bowel syndrome after surgery for Crohn’s often have problems with diarrhea and malabsorption. Talk with your child’s healthcare provider about how to treat this.
Children with short bowel syndrome often need help getting all the nutrition they need. Supplemental liquid feedings are sometimes done using TPN, or total parenteral nutrition. TPN is a special mix of glucose, protein, fat, vitamins, and minerals. It is given by IV or intravenously in the vein.
Call your child’s healthcare provider if your child has symptoms of Crohn's disease, including:
Call your child's provider right away if your child has Crohn's disease and regular symptoms change or new symptoms appear.
Tips to help you get the most from a visit to your child’s healthcare provider: