IBD (Crohn’s and Colitis)

Roy Nattiv, MD

Pediatric Gastroeneterologist

Diagnosing a treating children with gastrointestinal and nutritional issues.

What is Inflammatory Bowel Disease?

What is inflammatory bowel disease? Does IBD occur in children?

Inflammatory bowel disease (IBD) – also known as Crohn’s disease and ulcerative colitis, is a problem with the body’s immune system. While the immune system is normally responsible for eliminating foreign invaders such as bacteria and viruses, the immune system of patients with inflammatory bowel disease becomes confused and begins to attack the patient’s own intestine. When the immune system turns against ones own body it is called an autoimmune disorder. In this case, the autoimmune disorder is directed against the intestine and results in painful ulcers or sores along the gastrointestinal tract. Patients often have intermittent diarrhea that may be bloody. The intestine’s ability to absorb nutrition is also compromised and patients may become malnourished and lose weight. Patients may also have unusual rashes or unexplained fevers.

Symptoms of IBD

IBD may present with any number of symptoms. However, patients presenting with any three of the following four symptoms should be screened for IBD:

Abdominal Pain
Diarrhea (with or without blood)
Weight loss
Fevers

Testing for IBD involves several blood tests to check for inflammation circulating the blood stream – as occurs this with most autoimmune diseases. In addition, a stool test known as a fecal calprotectin can test for inflammation arising specifically from the intestinal lining. Finally, an upper endoscopy and colonoscopy are the gold standard in diagnosing IBD and can help determine the most appropriate treatment based on severity and location of these disease along the gastrointestinal tract.

Management and Treatment of IBD

There are many types of medications used to treat inflammatory bowel disease – most of which suppress the overactive immune system enough to prevent injury to the intestine but no much that the patient will be unable to defend themselves against common infections. Antibiotics are sometime prescribed to help wipe the gut of bacteria that may be the target of autoimmune inflammation. Probitoics have also shown to have some supportive role in treating IBD. Emerging scientific data to suggest that dietary therapy may play an even larger role than previously thought. There is no cure for IBD and it is a life-long diagnosis. It affects >300,000 in the US and is the subject a great deal of medical research. There are many new medications in the pipeline and a great number of support groups for patients teens and parents alike. There are even summer camps where teens with IBD are both camp-goers and counselors. Dr. Nattiv is the co-director of the Pediatric IBD Center at Miller Children’s Hospital and is always happy to chat with patients or parents who have any questions about IBD.

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