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Crohn's Disease

What is Crohn's disease?

Crohn's disease is an inflammatory bowel disease. It is a chronic condition that may recur at various times over a lifetime. It usually involves the small intestine, most often the lower part called the ileum. However, inflammation may also affect the entire digestive tract, including the mouth, esophagus, stomach, duodenum, appendix, or anus.

Crohn's disease is also called ileitis or enteritis.

What causes Crohn's disease?

There are many theories regarding Crohn's disease, but none has yet been proven. One theory suggests that some agent, perhaps a virus or bacteria, affects the body's immune system and triggers an inflammatory reaction in the intestinal wall. Although there is a lot of evidence that patients with this disease have abnormalities of the immune system, it is not known whether the immune problems are a cause or a result of the disease.

Physicians believe that there is little proof that Crohn's disease is caused by emotional distress or by an unhappy childhood.

Who is affected by Crohn's disease?

Twenty percent of all cases of Crohn's disease affect children. Crohn's disease is seen in children as young as seven years old. Males and females are affected equally. It appears to run in some families, with about 20 percent of people with Crohn's disease having a blood relative with some form of inflammatory bowel disease. In those who have a family history, it is very likely that Crohn's disease will begin in the teens and twenties.

What are the symptoms of Crohn's disease?

The following are the most common symptoms for Crohn's disease. However, each individual may experience symptoms differently. Symptoms may include:

Some people have long periods of remission when they are free of symptoms, sometimes for years. There is no way to predict when a remission may occur or when symptoms will return.

The symptoms of Crohn's disease may resemble other conditions or medical problems. Consult your child's physician for a diagnosis.

How is Crohn's disease diagnosed?

People who have experienced chronic abdominal pain, diarrhea, fever, weight loss, and anemia may be examined for signs of Crohn's disease. In addition to a complete medical history and physical examination, diagnostic procedures for Crohn's disease may include:

Illustration demonstrating upper endoscopy, part 1
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Illustration demonstrating upper endoscopy, part 2
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Illustration demonstrating upper endoscopy, part 3
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Illustration demonstrating a colonoscopy, part 1
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Illustration demonstrating a colonoscopy, part 2

Treatment for Crohn's disease:

At this time there is no cure for Crohn's disease; however, several methods are helpful in controlling it. The usual goals of treatment are to:

Specific treatment will be determined by your child's physician based on the following:

Treatment may include:

Illustration of bowel resection and colostomy
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Different types of ostomy are performed depending on how much and what part of the intestines are removed, and may include:

What happens if part of the bowel is removed, resulting in "short bowel syndrome?"

The intestines help to digest and absorb foods. Malabsorption occurs when food is not digested well and nutrients are not absorbed into the body. This can lead to poor growth and development. Children with short bowel syndrome (SBS) can have a reduced ability to absorb nutrients from the foods they eat. Malabsorption occurs because part of the intestines have been removed or are not functioning properly.

Common symptoms of malabsorption include the following:

Nutrition and short bowel syndrome:

Because diarrhea is the primary symptom of short bowel syndrome, the goal of the diet plan is to help control and/or reduce diarrhea and malabsorption. Guidelines that may help control diarrhea include the following:

Children with short bowel syndrome often need total parenteral nutrition (TPN) to help meet their nutritional needs. TPN is a special mixture of glucose, protein, fat, vitamins, and minerals that are given through an IV into the veins. Many people call it intravenous feedings. TPN provides the nutrients your child needs when he/she can not eat or absorb the nutrients from foods. The TPN solution is usually infused continuously over several hours of the day.

What is the long-term outlook for a child with Crohn's disease?

Crohn's disease is a chronic condition that may recur at various times over a lifetime. Children may experience physical, emotional, social, and family problems as a result of the disease, increasing the importance for proper management and treatement of the condition.

The following chart summarizes some of the problems children may face, according to the Pediatric Crohn's disease and Colitis Association.

Emotional Responses Social Problems Effects on the Family
Mood swings due to illness and medications

Blaming self for disease

Frustration with physical problems

Feeling different from everyone else

Anger: "Why me?"

Worry about appearance, slow growth, weight loss

Feeling vulnerable; unable to rely on body to function normally like everyone else

Frustration at physical limitations, being unable to keep up with friends

Coping with being teased by classmates

Embarrassment over frequent bathroom use

Peer pressure regarding food choices

Handling other people's lack of knowledge about the disease

Change in physical stamina

Changes in ability to concentrate on schoolwork

Understanding the needs of the child with Crohn's disease, as well as the rest of the family's needs

Need for mutual support of all family members

Need for all family members to learn about the disease and understand its effects on the child

Learning to cope with unexpected changes in family routine

Trying to channel frustration when angry

Respect for privacy

Encouraging independence of the child with Crohn's disease

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