When was the last time you had a stomachache? It's normal for all kids to get bellyaches once in a while. But some kids get bad stomach pain all the time. They are tired and even feel like they might throw up. Some of these kids may have what's called inflammatory bowel disease (or IBD).
About 1 million Americans have IBD, and 30,000 new cases are diagnosed each year. IBD, which can be diagnosed at any age, most often affects people between 15 and 35 years old but has even been found in children as young as 18 months old! In the United States, it's thought that as many as 100,000 kids younger than 18 years old have IBD.
So, just what is IBD? How do you know if you have it? And what help is available if you do?
What Is IBD?
Inflammatory (say: in-FLAM-uh-tor-ee) bowel disease is not a single ailment. It actually refers to a number of disorders that cause inflammation (say: in-fluh-MAY-shun) and, often, ulcers in the intestinal (say: in-TES-tuh-nul) tract. Ulcers are tears or breaks in the lining of the intestines that can cause pain or bleeding.
Your entire digestive (say: dye-JES-tiv) system is a long, hollow, muscular tube about 30 feet long. After you chew and swallow, food moves down your esophagus (say: ih-SOF-eh-gess) and into your stomach. It's the stomach's job to break food down into a liquid-y mixture. Muscles then push the mixture into your small intestine where your body completes digestion and absorbs needed nutrients from food.
After many of the nutrients are removed, the watery mix moves into your large intestine. In the colon (say: KO-lun), your body absorbs the remaining liquid and turns what's left into more solid waste. The colon then pushes the waste into the rectum (say: REK-tum), where it stays until you're ready to poop (have a bowel movement).
The two most common types of IBD are called Crohn's disease and ulcerative colitis (say: UL-sur-uh-tiv keh-LYE-tis).
Crohn's disease most often develops where the small and large intestines meet and usually causes all layers of the intestinal wall to become sore, inflamed, and swollen. Crohn's disease can affect any part of the digestive tract, including the mouth, esophagus, stomach, small intestines, large intestines, and anus.
Unlike Crohn's disease, ulcerative colitis inflames only the inner lining of all or part of the colon and rectum. Sometimes, only the rectum is affected. In both Crohn's disease and ulcerative colitis, inflammation may stick around for many years, flaring up over and over again.
Why Do Kids Get IBD?
No one knows exactly what causes IBD. Doctors don't think that IBD is caused by emotional stress or specific foods. You can't catch it from someone, like a cold, but the disease may be genetic or hereditary, meaning it is passed down in families. About 20% of people with the disease also have a relative who has it, too. Some researchers think that IBD may be caused by a defect in the body's immune (say: ih-MYOON) system.
The most common symptom of ulcerative colitis is loose (and bloody, if a person has ulcers) stools. Sometimes, going to the bathroom can be crampy and painful.
What Will the Doctor Do?
Because IBD may be mistaken for an infection or even depression, the disease is difficult to diagnose. Based on a person's symptoms, medical history, and physical exam, a doctor may do a blood test. Bowel movements are often checked to see if the intestines are bleeding or infected.
In some cases, doctors will do a test called a barium (say: BAIR-ee-um) swallow or an upper gastrointestinal X-ray series. First, you drink a thick liquid containing a substance called barium. (It can be chalky, but sometimes it's flavored.)
Another test that can be done is called an MRE, which stands for magnetic resonance enterography (say: mag-NETT-ik REZ-uh-ninz in-tur-OGG-ruh-fee). An MRE uses a magnetic field and radio waves to create detailed pictures of a person’s small intestine. Unlike X-rays, an MRE doesn't use radiation.
Then the doctor uses a special X-ray to track how the barium has gone down the esophagus and into the stomach. The barium is visible on the X-ray to give a clear picture of the stomach and intestines. A doctor also might use a special tool with a camera at the end (an endoscope) to take a look at what is going on inside the person's esophagus, stomach, small intestine, and large intestine.
If someone has IBD, the doctor may recommend a diet that is low in fiber, fat, and dairy products. He or she may also prescribe medications to reduce inflammation and help prevent infection.
Sometimes, surgery is necessary. Kids with ulcerative colitis can be cured by having their colon and rectum removed. There is no cure for Crohn's disease, but surgery often helps by removing parts of the bowel that are affected.
Inflammatory bowel disease is not a disease that kids will outgrow. However, many kids have long periods, sometimes years, when they are free of symptoms.
Some kids with IBD miss a lot of school. Those who get painful cramps, frequent diarrhea, or feel like vomiting have a hard time sitting through classes or riding a bus to and from school. Some who aren't getting the nourishment they need may go to the hospital where nutrients are fed to them through an IV.
In some cases, kids with IBD who grow or mature slowly may be treated with growth hormones. Some anti-inflammatory medications may also slow growth and cause other side effects, such as weight gain and a puffy face.
It's important for friends and classmates to understand that making fun of kids with IBD only makes matters worse. Friends and classmates should be sensitive and willing to listen when someone with IBD wants to talk. Simply talking about their illness can sometimes help kids with IBD feel a lot better about things.
The best thing that kids with IBD can do is take good care of themselves, exercise, take their medications, and eat foods that will make them grow strong but won't make their IBD act up. By managing their IBD, kids with this condition can lead regular lives.