Patient education: Crohn disease in children (The Basics)

What is Crohn disease? — Crohn disease is a condition that can cause diarrhea, belly pain, and other symptoms. It mainly affects the digestive system. The digestive system includes all the parts of the body that take in food and break it down into nutrients and waste. It includes the mouth, stomach, and intestines (figure 1).

Crohn disease happens when the body's infection-fighting system attacks and damages the lining of the digestive system. The infection-fighting system is called the "immune system." When it attacks the body's healthy cells, this is called an "autoimmune response." This is what happens in Crohn disease. The autoimmune response causes inflammation that can lead to sores (ulcers) and bleeding in the intestines and other parts of the digestive system.

What are the symptoms of Crohn disease in children? — The most common symptoms include:

●Belly pain

●Weight loss

●Diarrhea, blood in bowel movements, or both

●Being shorter or growing more slowly than normal

Some children with Crohn disease also get mouth sores, skin rashes, joint pain, liver problems, and eye redness.

The symptoms of Crohn disease can get better or worse at different times. So far, doctors do not have a cure for Crohn disease. But medicines and other treatments can help with symptoms.

Is there a test for Crohn disease in children? — Yes. Doctors can do the following tests:

●Blood tests

●Imaging tests – Such as X-rays, CT scans or MRI scans. Imaging tests show pictures of the inside of the body.

●A test called a "colonoscopy" – This test looks at the lining of the large intestine (figure 1). During this test, a doctor puts a thin tube into the rectum and moves it up into the last part of the digestive system, called the "colon." The tube has a camera on the end so the doctor can look inside the colon (figure 2).

●A test called an "upper endoscopy" – This test looks at the lining of the stomach and upper part of the small intestine, called the "duodenum." During this test, a doctor puts a thin tube with a camera on the end into a person's mouth and moves it down into the stomach and duodenum (figure 3).

Doctors usually need to do all these tests to know for sure if a child has Crohn disease.

How is Crohn disease in children treated? — There are many different medicines that can help with symptoms of Crohn disease. Some medicines are used when symptoms are very bad. Other medicines help keep symptoms from starting or coming back. Your child might have to try a few different medicines and take several medicines to control symptoms.

Some children with Crohn disease need to drink a special formula for a few months. Doctors might recommend only formula instead of food for a while, or formula in addition to eating a limited diet. This can help the lining of the digestive system heal. It might also help your child get the nutrients they need to grow. The doctor will also check your child's height and weight to make sure they are growing as normally as possible.

Crohn disease can make it hard a child to get enough nutrients from food. Your child might need vitamin supplements to get extra nutrients. Supplements are pills, capsules, or liquids that have nutrients in them.

Will my child need surgery for Crohn disease? — Your child might have surgery if medicines do not help with symptoms. Or doctors can do surgery if Crohn disease causes certain problems. Doctors can:

●Remove diseased tissue

●Reopen a part of the digestive system that is blocked

What will my child's life be like? — People with Crohn disease often need treatment for life. But with treatment, many people can live fairly normal lives.

Children with Crohn disease might be shorter than other children their age or go through puberty later. Puberty is a term for the body changes that happen as a child becomes an adult. Your child might feel embarrassed or anxious about being different. They might have other worries, and you might, too. Getting counseling or joining a support group can help you and your child cope.

Crohn disease can increase the risk of colon cancer. Experts suggest that people with Crohn disease that affects the colon get screened early and often. This might mean having a colonoscopy about 8 years after Crohn disease is found and once a year after that. Doctors can look for signs of colon cancer and treat it if they find it.

More on this topic

Patient education: Diarrhea in children (The Basics)
Patient education: Late puberty (The Basics)
Patient education: Ulcerative colitis in children (The Basics)

Patient education: Chronic abdominal pain in children and adolescents (Beyond the Basics)
Patient education: Crohn disease (Beyond the Basics)