Crohn’s disease affects about half a million people in the U.S. While most people with the condition are adults, doctors are also starting to see an increasing number of kids with Crohn’s disease.
“Crohn’s disease is becoming more common in younger patients,” says Seth Iskowitz, M.D., a pediatric gastroenterologist at Henry Ford Health. “The majority of children are diagnosed in their early teens, but it can sometimes present much earlier.”
What Is Crohn’s Disease?
Crohn’s disease is a type of inflammatory bowel disease (IBD). People with Crohn’s disease have inflammation in their digestive tract. The inflammation can occur anywhere from the mouth to the anus. But in kids, it’s most common in the last part of the small intestine and throughout the large intestine.
With Crohn’s disease, the affected parts of the digestive tract are chronically inflamed. “This makes it harder for those parts of the digestive tract to do their jobs,” says Dr. Iskowitz.
The exact cause of Crohn’s disease is still unclear, but research suggests that genetics may play a role. Kids with a parent or sibling who has IBD may be more likely to get Crohn’s disease.
Crohn’s Disease Symptoms In Kids
Crohn’s symptoms can come and go. In some cases, kids can go months or even years without symptoms before they reappear. A period of time without symptoms is called remission.
Your child’s symptoms will depend in part on which area of the digestive tract is involved. “We often see kids whose only symptom is that they are not growing. This happens when the inflammation is in the small intestine,” says Dr. Iskowitz. “It’s the small intestine’s job to absorb the nutrients kids need to grow, but inflammation can interfere with this absorption,” says Dr. Iskowitz. In pre-adolescents, this can result in delayed puberty and for teens, loss of menstrual cycles.
Other common symptoms can include:
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- Bloody stools
- Loss of appetite
- Stomach pain
- Unexplained
- Weakness (due to anemia from not absorbing iron in food)
How Crohn’s Disease Is Diagnosed In Kids
“Kids are likely born with a genetic predisposition to Crohn’s disease,” says Dr. Iskowitz. “Parents often worry that it’s something they did or something they fed their child, but if you have a genetic predisposition, it’s usually just a matter of time before the disease presents itself.”
Diagnosing Crohn’s disease typically involves a series of tests. “We usually start with a stool test to look for signs of infection or inflammation,” says Dr. Iskowitz. “But in order to accurately diagnose Crohn’s, we need to look at the entire gastrointestinal [GI] tract.”
That means a combination of:
- Colonoscopy, to look at the lower part of the GI tract
- Esophagogastroduodenoscopy (EGD), to look at the upper part of the GI tract
- MRI enterography (MRE), to produce detailed images of the entire GI tract and to look for specific complications
Treating Pediatric Crohn’s Disease
Kids with Crohn’s disease typically take medications throughout their life. “We can’t cure Crohn’s disease, but the vast majority of kids respond well to medication,” says Dr. Iskowitz. “The goal is to put them into complete remission where they no longer have any symptoms.”
Changing diet hasn’t been shown to maintain remission (without also taking medication). But other lifestyle factors—like learning ways to better manage stress—may play a role. In rare cases, children may need surgery to remove a part of the bowel that’s chronically inflamed and not responding to medication.
Managing Crohn’s disease with medication is a lifelong process. “Your child’s medication doses may need to change as they get older—especially as they go through puberty,” says Dr. Iskowitz.
That’s why kids with Crohn’s need careful monitoring. It’s important to find a provider who will work with your child, your family and other specialists as a team. Together, your pediatric gastroenterologist, nutritionist, psychologist and others will help keep your child feeling well.
Reviewed by Seth Iskowitz, M.D., a pediatric gastroenterologist who sees patients at Henry Ford Medical Center - Royal Oak.
