Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease (IBD) is an inflammation or swelling in the gastrointestinal tract.  There are two types of IBD: ulcerative colitis and Crohn's disease. These diseases are not contagious. 

About 1.4 million Americans have IBD. Thirty thousand new cases are diagnosed every year.

Young people between the ages of 15 and 35 are most likely to get IBD, but anyone can get it. It is more common in Caucasians. IBD is especially common in those who are Jewish.

Ulcerative colitis affects only the colon. It usually involves the rectum and can affect areas up into the colon. If it affects the whole colon, it is called pancolitis.

Crohn's disease can involve any part of the gastrointestinal tract, from the mouth to the anus.

Gastrointestinal Tract

Ulcerative colitis involves only the lining of the bowel (not the entire thickness of the bowel wall).

Crohn's disease affects the entire thickness of the intestinal wall.

Patients with ulcerative colitis and those with Crohn's disease that involves the colon have a greater risk of getting colon cancer, and this risk increases over time.

Although the exact cause of IBD is not known, these are thought to play a role in both ulcerative colitis and Crohn's:

  • Genetic tendency: Certain genes you were born with, like family traits, make it more likely that you will get IBD
  • Environmental trigger: Something you are exposed to like medications, infections or toxins
  • Immune system: The patient’s immune system reacts inappropriately.  For example, it interprets good bacteria as something harmful and attacks it, which causes inflammation
  • Bacteria that are normally in the intestine: The good and bad bacteria that belong in the intestine are not balanced

Ulcerative colitis and Crohn’s disease have many similar symptoms, including:

  • Diarrhea
  • Rectal bleeding
  • Abdominal (belly) pain
  • Decreased appetite
  • Weight loss
  • Fever

Although some symptoms can be similar to other illnesses, inflammatory bowel disease is a chronic, or long-term condition which does not resolve on its own after several days.

Ulcerative colitis and Crohn’s disease both have times when disease symptoms go away (remission).  They also both have times when symptoms become more severe (flare). The symptoms, types and severity are unique to each individual.

Because Crohn’s disease and ulcerative colitis share many of the same symptoms, it may be difficult to correctly diagnose which condition a child is suffering from.  Additionally, IBD is sometimes mistaken for irritable bowel syndrome (IBS), which also shares many of the same symptoms.  Diagnosing these diseases requires several tests:

  • Blood tests – to check for anemia (low red blood cell count).  The tests can also show if there is an increased number of white blood cells, which might mean that there is an infection or inflammation somewhere in the body.
  • X-rays – special CT scans, MRIs and barium X-rays to look for inflammation, swelling or narrowing of the intestine
  • Endoscopy (looking inside the bowel with a flexible tube)

The ultimate goal of treatment is to make symptoms go away and keep the patient in remission (no symptoms). 

Medicine is tried first to help control swelling and irritation for both ulcerative colitis and Crohn's disease.  There are several types of medications used to control the swelling and irritation.  Medications are chosen based on where the disease is located and the severity of the irritation.   In many cases, medications work to control both diseases, so surgery is not needed for a very long time.

Because of the inflammation with IBD, the intestine is unable to do its job of breaking down food and absorbing the nutrients. This can cause poor growth, poor weight gain and poor nutrition. The IBD team includes dietitians who are experts in evaluating nutrition and who work with patients and families to create an individual nutrition plan. The goal is to ensure each patient is getting a variety of foods, enough calories, and nutrients to support growth and development.

Enteral (nutritional) therapy may be helpful in some patients with IBD. Patients who are felt to be a good candidate for enteral nutrition receive support and guidance from our expert IBD dietitians.

Surgery may be recommended when medicine cannot control the symptoms or when there are other medical problems. Surgery for Crohn's disease may help relieve constant symptoms or correct problems. It is not a cure for Crohn's disease because the disease usually comes back.

Ulcerative colitis can be cured by removing the colon (colectomy). Colorectal surgeons in Cincinnati Children’s Peña Colorectal Center are among a very few in the country who can perform minimally invasive (laparoscopic) surgeries on children and teens with IBD.

Contact the the Schubert-Martin Inflammatory Bowel Disease Center at Cincinnati Children's at 513-636-4415 or

Last Updated 06/2015