Crohn’s Disease in Children

Introduction:

Crohn's disease, a chronic inflammatory bowel illness once regarded as uncommon in the pediatric population, is now considered one of the most significant chronic conditions affecting children and adolescents. Twenty to thirty percent of the people with Crohn's disease present before the age of twenty. In addition to the typical gastrointestinal symptoms like diarrhea, rectal bleeding, and abdominal pain, children with Crohn's disease frequently suffer from development failure, malnutrition, pubertal delay, and bone demineralization.

What Is Crohns Disease in Children?

Crohn's disease causes redness, swelling (inflammation), and sores along the digestive tract. It belongs to the group of conditions known as inflammatory bowel disease. Crohn's disease is a persistent (chronic) illness. It may occur intermittently during the child's life.

In the majority of instances, it affects the small intestine, specifically the ileum. In certain cases, both small and large intestines are damaged. Inflammation can sometimes impact the entire digestive tract. This includes the mouth, the food pipe (esophagus), the stomach, the duodenum, the appendix, and the anus.

What Are the Causes of Crohns Disease in a Child?

Multiple factors contribute to the causation of Crohn's disease. The disease development requires a combination of predisposing genetic factors, environmental variables, host factors, and a triggering event. Diet and stress may exacerbate symptoms but most likely do not cause the illness. Crohn's disease is often inherited. However, not all patients have Crohn's or IBD family history.

What Are the Symptoms of Crohns Disease?

Symptoms may differ amongst children. Possible symptoms include:

• Typical lower right abdominal pain.

• Loose stool (diarrhea), sometimes bloody stools.

• Rectal bleeding.

• Losing weight.

• Fever.

• Slower development.

• Joint discomfort.

• A laceration or tear of the anus (anal fissure).

• Rashes.

Some children may go years without experiencing any symptoms. This is referred to as remission. There is no way to tell when remission will occur or when the child's symptoms will return. The symptoms of Crohn's disease may resemble those of other diseases. Always seek a diagnosis from the child's healthcare provider.

How Is Crohns Disease Diagnosed?

The healthcare provider will conduct a health history and physical exam. Other Crohn's disease investigations may include:

• Blood Testing: These are performed to determine whether or not the child has less healthy red blood cells due to blood loss. These tests also determine if the child has an elevated white blood cell count. This could indicate an inflammatory issue. Other types of blood tests can detect abnormal antibodies. The healthcare provider may utilize this result to diagnose or classify disease.

• Stool Culture: This is done to determine whether a parasite or bacterial infection is causing the symptoms.

• Endoscopy: This test examines the gastrointestinal tract. It employs a thin, flexible tube known as an endoscope. The end of the tube has a light and a camera lens. Biopsies or tissue samples from the digestive tract may also be collected for testing.

• Colonoscopy: This procedure examines the entire length of the big intestine. It can aid in detecting abnormal growths, inflammatory tissue, sores or ulcers, and bleeding. A colonoscope is a long, flexible tube inserted into the child's rectum and colon. This tube lets the provider see the colon's lining and get a tissue sample or biopsy for testing.

• Biopsy: A tissue sample is removed from the colon lining and analyzed in a laboratory.

• Upper Gastrointestinal Series or Barium Swallow: This test examines the organs of the upper digestive tract. It examines the esophagus, the stomach, and the beginning of the small intestine (duodenum). The child will consume a fluid known as barium. This fluid is thick and chalky. It covers the interior of organs to make them visible on x-rays. Then, x-rays are examined to obtain the diagnosis.

• Lower GI Series or Barium Enema: This examination examines the large intestine, which includes the colon and rectum. Barium is a viscous, chalky fluid that is placed in a tube. As an enema, it is inserted into the child's rectum. The organs are coated with barium to be viewed on an x-ray. An x-ray of the child's abdomen will reveal any narrowed areas, known as strictures. It will also reveal any obstructions or other abnormalities.

• CT Enterography or Magnetic Resonance Enterography: These imaging studies can detect inflammation or problems in the small intestine.

• Capsule Endoscopy: This is a unique capsule that the child is made to consume. The capsule is a camera that takes images of the small intestine.

How Is Crohns Disease Treated?

Crohn's disease is a chronic (long-term) condition and has no cure for this condition. However, several things can help to cope with the situation. The treatment includes four goals:

• Resolving dietary issues.

• Reduce edema and inflammation.

• Reduce symptoms such as stomach pain, diarrhea, and rectal bleeding.

• Prevent further complications, including inflammation of other organs (fistulas) and intestinal narrowing (stricture) that produce obstructions.

The child's doctor will develop a care plan based on the following factors:

• The age, general health, and medical history of the child.

• The seriousness of the disease.

• How well the child tolerates specific medications, treatments, or therapies.

• If the child's condition is likely to deteriorate,

The following treatments may be given to the child which is as follows:

• Medicines: Medicines typically reduce inflammation in the colon. This helps with stomach pains and diarrhea. More serious cases may necessitate the use of steroids, antibiotics, or medications that affect immunity.

• Diet: Changing the child's diet may assist in easing the symptoms. In certain situations, milk, hot spices, or fiber-rich food may aggravate symptoms. Consult the child's provider regarding the diet plan for the child. In some cases, the child may be on a specific diet known as an elemental diet.

• Nutritional Supplements: The child's doctor may recommend nutritional supplements or high-calorie liquid formulas. These may be beneficial if the child's growth is delayed.

• Vitamins: Vitamins help avoid some disorders or keep remission going. Vitamin deficits are prevalent in children with Crohn's disease because they do not absorb nutrients normally. The youngster may require laboratory tests to determine nutritional levels. Discuss vitamin supplements with the child's provider and follow the physician's instructions.

• Intravenous Feeding: In rare situations, IV feeding may be utilized for children who require more nutrition for a short period.

• Surgery: Crohn's disease can be helped with surgery, but it cannot be cured. Long-term symptoms that do not improve with medication may benefit from surgery. Some issues may also be resolved surgically. A blocked gut, a hole or perforation, a sore or abscess, or bleeding can be fixed through surgery.

Can Crohns Disease be Prevented in Children?

As Crohn's disease has no proven cause, there is no known strategy to avoid it. Some experts believe regulating environmental factors may reduce a child's likelihood of developing Crohn's disease. This includes selecting choices that are gentle on the child's digestive system.

Conclusion:

Crohn's disease is usually not fatal. Most children do exceptionally well and can attend school, participate in sports, and go about their daily lives with proper medication and care. However, life with Crohn's disease can be difficult. Parents or children may sometimes be dissatisfied, angry, or resentful. It can help to have someone to talk to about their situation. People in similar situations form support groups. They provide solace, motivation, and inspiration. They also offer beneficial coping skills for this condition. Support groups can help parents, siblings, and the affected child. Support groups can meet in person, by phone, or online.