Inflammatory Bowel Disease in Children.

According to experts from the Pediatric Inflammatory Bowel Disease Center at Johns Hopkins Children’s, inflammatory bowel disease today is increasingly common in kids, which was once a medical rarity in children, but many of them may not be diagnosed in a timely manner.

 Inflammatory Bowel Disease in Children

Gastroenterologists there say that many of the hundreds of children they see were referred to them only after repeated visits to their primary-care physicians for symptoms mistakenly attributed to common GI ailments like viral gastritis.

Inflammatory Bowel Disease (IBD) is still considered an adult condition and is rarely on pediatricians’ radars,” says Maria Oliva-Hemker, M.D., chief of the Gastroenterology & Nutrition division at Hopkins Children’s and director of the Comprehensive IBD Center there. “Fifty years ago, IBD was almost exclusively diagnosed in adults. These days, treating children with IBD is business as usual in our clinics.”

The 2 main forms of inflammatory bowel disease are Crohn’s Disease and Ulcerative Colitis. Maria Oliva-Hemker says that Crohn’s disease seems to be rising more rapidly in children than ulcerative colitis, for unknown reasons.

Children with Crohns Disease also tend to be diagnosed later than those with ulcerative colitis because the most common symptom is vague abdominal pain rather than the more suggestive bloody stools seen in ulcerative colitis.

It is most commonly diagnosed in school-age Children and teens but Hopkins Children’s gastroenterologists say that they have seen the disease in a growing number of children younger than 5 years of age.
Delays in treatment can make IBD worse and lead to severe anemia from gastrointestinal bleeding, malnutrition, poor food absorption and stunted growth.
IBD can cause serious damage to the colon and small intestine that requires surgery, in advanced cases.

To prevent dangerous delays in diagnosis and treatment, the following symptoms should prompt a visit to a specialist:
(especially if they keep coming back or never fully go away)
• abdominal pain
• bloody stools
• diarrhea
• nausea and/or vomiting
• poor appetite and weight loss
• poor growth, especially in younger children
• pale skin, rapid heartbeat, fatigue and dizziness, all of which could indicate chronic anemia from GI bleeding
• a family history of IBD — up to 30 percent of childhood cases have genetic roots.

Oliva-Hemker advises pediatricians who suspect IBD to obtain routine blood tests to check for anemia and inflammation markers like elevated sedimentation rate and C-reactive protein. The diagnosis can usually be confirmed with an endoscopy and colonoscopy.

14 April 2011