Is it Just a Stomachache? Understanding IBD
The symptoms of inflammatory bowel disease (IBD) can come and go. That makes it easy to disregard the warning signs of this chronic illness. But rather than making the disease go away, ignoring symptoms of abdominal pain, diarrhea and painful bowel movements can actually aggravate the condition and lead to serious health issues.
Is Your Child at Risk?
IBD refers to chronic inflammatory disorders involving the gastrointestinal tract. Ulcerative colitis and Crohn's disease, subsets of IBD, can occur at any age, but they are most prevalent between the ages of 15 and 30. Nearly 1 million Americans have IBD.
The causes of IBD are unknown. "We know there is a genetic predisposition," says Susan Moyer, MD, medical director of the Schubert-Martin Inflammatory Bowel Disease Center at Cincinnati Children's Hospital Medical Center. "If your sibling has IBD, your risk increases."
Environmental triggers are also a factor. Intestinal infection and exposure to medication can trigger an initial inflammation that the body simply cannot heal. "That's what makes IBD chronic," explains Dr. Moyer. "The inflammation just keeps going."
Watch for the Signs
Symptoms of ulcerative colitis – which affects only the large intestine – include blood in the bowel movement, diarrhea and painful bowel movements. Although the condition is chronic, the symptoms are not. "This is an issue with children, because they won't tell you unless it really bothers them," Dr. Moyer says. "Then you'll find out that they've been having intermittent bouts of diarrhea and blood in their stools for months."
Crohn's disease can affect any part of the gastrointestinal tract. Symptoms depend on where the inflammation occurs. Pain high in the abdomen, vomiting, loss of appetite, diarrhea and weight loss are all symptoms of this disease. Like ulcerative colitis, Crohn's can cause painful bowel movements, diarrhea and blood in the stool.
In some cases, stunted growth is the only symptom of Crohn's inflammation. "That's one of the red flags for us, particularly if it is associated with stomachaches," says Dr. Moyer. "The inflammation prevents the body from responding to growth hormone."
Medical diagnosis of IBD begins with a complete physical exam and family history. Blood tests, stool cultures, X-rays and other tests might also be performed to support a diagnosis of IBD. To make a definitive diagnosis and to determine whether the condition is ulcerative colitis or Crohn's disease almost always requires performing a colonoscopy and upper endoscopy. This involves examining the lining of the bowel through a flexible tube with a bright light on the end.
Addressing IBD
Treatment for IBD varies from person to person. For most, the initial treatment involves prednisone steroids, which decrease inflammation. Then, anti-inflammatory drugs are prescribed. If symptoms are severe, a physician might prescribe drugs that suppress the immune system.
Surgery is needed if symptoms are very severe and do not respond to other treatments. Ulcerative colitis can be cured by surgically removing the colon. There is no cure for Crohn's disease, but surgery is often required to mend holes or tight areas in the bowel.
Quality of Life
Although the symptoms might vary over time, ignoring them can result in serious health issues. "Children with severe symptoms might not be able to eat. They'll lose weight and become malnourished and anemic," says Dr. Moyer. "Left untreated, IBD can make them pretty sick.
"It's important to recognize and diagnose these diseases as soon as you can because they can have long-term consequences, such as stunting of growth. They can impact your quality of life significantly," Dr. Moyer concludes. "Fortunately, with care and medication, people who have IBD can manage the symptoms and lead active lives."
