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 of 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).

When a person has Crohn disease, their immune system (the body's infection-fighting system) attacks the lining of their digestive system. This causes inflammation, which can lead to sores (ulcers) and bleeding inside the body.

So far, doctors do not have a cure for Crohn disease. But medicines and other treatments can help with symptoms.

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.

Symptoms can get better or worse at different times.

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

●Blood tests

●Tests on bowel movements – These tests look for blood, inflammation, and infection.

●Imaging tests – Imaging tests show pictures of the inside of the body. Examples include X-rays, CT scans, and MRI scans.

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

●"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 of 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 they might recommend 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 that they need to grow. The doctor will also check your child's height and weight to make sure that they are growing as normally as possible.

Crohn disease can make it hard for 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? — Most children with Crohn disease do not need surgery. Your child might have surgery if Crohn disease causes certain problems.

Surgery might be needed to:

●Remove parts of the intestine that are leaking (called a "perforation")

●Re-open parts of the intestine that have become blocked

●Remove the diseased part of the colon

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.

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.

When should I call the doctor? — Call for advice if your child:

●Has signs of infection – These include a fever of 100.4°F (38°C) or higher, and chills.

●Has very bad belly pain

●Has diarrhea more than 6 times in 24 hours

●Has bloody or black bowel movements

●Is having trouble coping with their Crohn disease

More on this topic

Patient education: Diarrhea in children (The Basics)
Patient education: Bloody stools in children (The Basics)
Patient education: Ulcerative colitis in children (The Basics)
Patient education: Late puberty (The Basics)
Patient education: Low-FODMAP diet (The Basics)

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