SSM Health Medical Minute: Diagnosing inflammatory bowel disease in children

ST. LOUIS - Inflammatory Bowel Disease (IBD) is a chronic or recurring inflammation of the gastrointestinal tract. The two most common types of inflammatory bowel disease are Crohn’s disease (CD) and ulcerative colitis (UC). Most cases of IBD are diagnosed before the age of 35, making it one of the most significant chronic conditions affecting children and adolescents in the US.

SLUCare's Dr. Jeff Teckman, is a pediatric neurogastrointestinal specialist at SSM Health Cardinal Glennon Children's Hospital.  The hospital has made major progress in treating hundreds of children with IBD.  Dr. Teckamn says IBD often causes growth problems, "They may be a twelve year old but are the size of a nine year old and being the smallest kid in the class, the weakest kid in the class that's tough on kids. When we make the right diagnosis and initiate treatment and over the next couple of years that kid goes from being the smallest kid in the class to regular size and on the sports teams."

Occasionally, it can be difficult to determine if a child has Crohn’s disease or ulcerative colitis as both conditions cause similar symptoms, including:

  • Abdominal pain
  • Diarrhea
  • Failure to gain weight or grow
  • Fatigue
  • Fever
  • Rectal bleeding
  • Relapsing gastrointestinal illness over several months

Your child may receive a preliminary diagnosis of indeterminate colitis (IC) when it’s unclear if they have Crohn’s disease or ulcerative colitis. If you or your child’s doctor suspect IBD, it’s important to see a well-trained pediatric gastroenterologist. Over time, IBD can prevent proper absorption of vital nutrients and impede a child’s overall health.

But, Dr. Teckman says, "We also have new treatment trials for new drugs. We're enrolling treatment trials right now for some new treatment for IBD in children and these treatments are not always available at all centers."

Causes of IBD
In the US, inflammatory bowel disease affects approximately 1.6 million people, including as many as 80,000 children. However, the exact cause of IBD is not well understood. What researchers do know is that IBD is likely the result of environmental and immune system factors.

If your child has IBD, their immune system does not respond normally and mistakes food, bacteria and other materials of the intestine as foreign or invading substances. As a result, their body floods the intestines with white blood cells to fight the substances, resulting in chronic inflammation and ulcers.

Adults and children with IBD may have similar symptoms but children can develop unique complications such as growth failure and delayed puberty.

Most cases of inflammatory bowel disease are diagnosed between the ages of 15 and 35, however, younger children are also prone to showing symptoms of this chronic disease.

IBD is preliminarily diagnosed after reviewing your child’s symptoms and blood test results. A firm diagnosis is then only established by radiographic studies and endoscopy, including biopsies. To see if your child has Crohn’s disease, ulcerative colitis, or indeterminate colitis, we might order a number of additional tests, including:

  • Blood panels
  • Stool sample
  • Endoscopy
  • Colonoscopy
  • Biopsy
  • Imaging studies (X-ray, CT scan, MRI)

To learn more about IBD, click here.

The SSM Health Medical Minute airs every Wednesday at 7 pm on KPLR News 11 and at 9 pm on KTVI Fox 2 News.​

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