Inflammatory bowel disease (IBD) is a general name for chronic diseases that cause inflammation in the gastrointestinal tract. The two most common types of IBD are Crohn's disease and ulcerative colitis.
The incidence of IBD is increasing worldwide and approximately a third of patients are diagnosed during childhood or adolescence. The Pediatric Inflammatory Bowel Disease Center at Hasbro Children’s Hospital provides state-of-the-art, multidisciplinary care to over 500 children with IBD.
If your child has been diagnosed with IBD, chances are you have a lot of questions. This time of diagnosis can be confusing and overwhelming. Remember, you are not in this alone. We are here to support you and your family. We want to answer your questions and work with you to provide the very best care for your child so that you can help your child lead a full life.
Signs and Symptoms of IBD
Children and adolescents with IBD can present with a spectrum of signs and symptoms. In Crohn’s disease and ulcerative colitis; children have periods of no symptoms alternating with periods of inflammatory symptoms. Symptoms are due to inflammation of the gastrointestinal tract and may show signs in the following ways:
- Abdominal pain
- Anemia and/or iron deficiency
- Joint pain and swelling
- Mouth ulcers
- Persistent diarrhea
- Rectal bleeding and/or blood in stool
- Weight loss and/or growth problems
Diagnosis of IBD
Many tools can be used to confirm a diagnosis of pediatric IBD. In addition to an initial physical exam and medical history, diagnosis is based on a thorough workup inclusive of a few types of tests:
- Blood tests
- Radiographic tests such as MR enterography
- Stool culture
- Upper endoscopy
Treatments for IBD
IBD can be controlled, but there is no known cure. Treatment is complex and may involve medical management, surgery, or diet and nutrition changes.
- Medical Management
Medical treatment plans involve a variety of medications that decrease the immune response to varying degrees. A major advance in the treatment of IBD is the increased use of medications such as infliximab (Remicade), adalimumab (Humira), vedolizumab (Entyvio) and ustekinumab (Stelara). These medications, commonly referred to as biologics, are antibody-based agents that preferentially bind to proteins involved in the inflammatory cascade. While infliximab and vedolizumab are given via intravenous therapy (IV) at varying intervals in our Infusion Center at the Tomorrow Fund Clinic, adalimumab and ustekinumab are injectable medication that patients can receive at home. There are number of new medications in various phases of development. Hasbro Children's Hospital will be a study site for a number of these clinical trials.
Some patients may require surgery. Patients with Crohn’s disease may undergo surgery for strictures, fistula and/or bowel obstruction. With ulcerative colitis, some patients may eventually need a complete removal of the large intestine.
- Diet and Nutrition
Diet and nutrition choices do not cause or cure IBD, but reducing or increasing intake of certain foods may help decrease symptoms. It’s important to make sure a child is getting the appropriate nutritional support to reverse any dietary deficiencies that come with IBD (e.g., anemia, iron deficiency). In this regard, our center includes registered dietitians with expertise in counseling children and families with IBD.
Caring for the Whole Child
Our patients and families receive care from a myriad of inpatient and outpatient providers. From Child Life to the exceptional nursing staff in our GI clinic and the Tomorrow Fund, our patients have access to a dedicated, world-class care team. Adjusting to a diagnosis of IBD can be exceptionally challenging for some children. In addition to outpatient access, child psychology, and social work, the Partial Hospital Program and Medical/Psychiatric Unit represent an important resource for some of our more complex patients.
Lifespan sponsors many clinical trials. This research helps us provide the best treatments for our patients.