Approximately 1.4 million Americans live with inflammatory bowel disease, including many children, adolescents, teens and young adults. Some people experience only mild symptoms while others have more severe Crohn's disease or ulcerative colitis. Early diagnosis and treatment are important for the ongoing management of the disease.

Pediatric IBD Symptoms

Symptoms of Crohn's disease and ulcerative colitis may include:

  • Abdominal pain
  • Anemia and/or iron deficiency
  • Joint pain and swelling
  • Multiple or recurrent mouth ulcers
  • Persistent diarrhea
  • Rectal bleeding and/or bloody stools
  • Weight loss and/or growth problems

You may notice other signs, such as the development of a fever, rash, loss of appetite or abnormal menstrual cycles.

Tools for Diagnosis

Physicians use many tools to confirm or rule out a diagnosis of inflammatory bowel disease. Our team will start by performing a comprehensive history and physical exam. We may order some or all of the following tests:

  • Blood tests to check for anemia and levels of inflammation
  • Colonoscopy to examine the colon and terminal ileum (small intestine)
  • Imaging studies, such as a small bowel follow-through X-ray series or MRE (magnetic resonance), to assess the small and large intestine
  • Stool culture to check for various infectious agents
  • Upper endoscopy to examine the esophagus, stomach and duodenum (the first part of the small intestine)

Treatment for Pediatric IBD

IBD is a chronic disease that can be controlled, but we do not yet have a cure. Patients experience flares when symptoms are present, followed by periods of remission. The goal of treatment is to help all patients achieve remission, control symptoms, experience normal growth and lead a normal life.

Medications typically are the first line of treatment for Crohn's disease and ulcerative colitis. Many different types of drugs can help control inflammation in the digestive tract. While these medications do not cure IBD, they can alleviate or eliminate symptoms and lead to remission. The team at Comer Children's has access to the latest medical advances in IBD care and will work with your family to create a personalized treatment plan that is best for your child's condition.

In more severe cases of inflammatory bowel disease, surgery may be necessary. Patients with Crohn's disease may need surgery for strictures, fistula and/or bowel obstruction. Some patients with ulcerative colitis may eventually require complete removal of the large intestine.

We recognize that surgery is stressful and that you will probably have a lot of questions. That's why our team of gastroenterologists (experts in the diagnosis and treatment of disorders of the stomach and intestines) and surgeons work together to provide support while also helping you find the right solution for your child. Many of our pediatric surgeons specialize in minimally invasive procedures, which reduce scarring and help children return to activities faster than traditional surgery.

Your physician may discuss dietary changes for your child. Although there is no data to suggest that diet causes or cures IBD, reducing or increasing the intake certain foods may help decrease your child's symptoms. We also make sure he or she is getting the appropriate nutritional support to reverse any dietary deficiencies (lack of essential nutrients) and provide the nutrients needed for normal weight gain, growth and puberty.

Frequently Asked Questions

Experts at the University of Chicago Medicine Comer Children's Hospital welcome the opportunity to provide a second opinion on the diagnosis or management of your child's inflammatory bowel disease. Our gastroenterologists are at the forefront of IBD clinical care and research. In addition, we work closely with leaders in a variety of other specialties, who consult and provide care as needed. Our team will help you understand your options so that you can choose the best treatment plan for your child.

The exact cause of Crohn's disease and ulcerative colitis is unknown. However, there is strong evidence to suggest that genetic predisposition — along with environmental factors and an abnormality in a person's immune system — plays a role in the development of inflammatory bowel disease. As a result, these diseases tend to cluster among relatives. Our experts specialize in providing care for families in which multiple members (often across several generations) have been diagnosed with IBD.

Although the risk of IBD is higher for people who have a sibling or parent with the disease than it is for the general public, it does not mean that your other children will develop it. If you notice these symptoms, please discuss these concerns with your child's pediatrician.

No, IBD and IBS are very different. IBS is an acronym for irritable bowel syndrome, a functional gastrointestinal disorder. In IBS, the structure of the colon — including appearance on colonoscopy and biopsy — looks normal (that is, the inflammation that occurs in inflammatory bowel disease is not evident), despite causing uncomfortable symptoms such as abdominal pain, diarrhea, constipation, gas and/or bloating. Irritable bowel syndrome does not cause extra-intestinal symptoms or long-term damage to a person's colon. Some patients with IBD also have IBS.

We recognize that every child's needs are different, and there is no "right" time to begin the transition of care from a pediatric to an adult gastroenterologist. Often, the process begins in late adolescence, when the child leaves for college or moves out of the home. Our Transitional IBD Clinic — one of the few in the country — is designed to meet the unique needs of teens and young adults, ages 15 to 21. Our goal is to create a bridge between pediatric and adult care by providing the tools and support that our young adult patients need in order to take a more active role in IBD management.

For patients who attend college out-of-state, we will help identify a local physician to provide ongoing care. Our team will work closely with both your child and the local gastroenterologist to ensure continuous and comprehensive care. When patients are ready, we will facilitate transfer of care through our Transitional IBD Clinic directly to one of our adult IBD specialists. For patients leaving the Chicagoland area, we can provide referrals through our network of IBD specialists across the U.S. and around the world.

The Child Life and Family Education Program at Comer Children's provides support for children of all ages with inflammatory bowel disease. Our child life specialists are trained in childhood development and use this knowledge to provide age-appropriate educational, developmental and therapeutic services to help children adjust to the challenge of living with a chronic disease.

The University of Chicago Medicine also offers a monthly support group for patients with inflammatory bowel disease. Older teenagers and young adults are welcome to attend the meetings, which occur the second Monday of every month.

In addition to our internal resources, many families find support through the Crohn's & Colitis Foundation.

Please note, we provide this link as a service to our site visitors. The University of Chicago Medicine is not responsible for information or services provided on external websites.

What Parents Need to Know about Kids and IBD

More children are being diagnosed with inflammatory bowel disease, and symptoms can start as early as 18 months old. But once treatment brings inflammation under control, kids can lead a normal life: going to school, playing sports and even eating most of their favorite food. Comer gastroenterologist Ranjana Gokhale, MD, shares her expertise.