Pediatric Crohn’s Disease

Pediatric Crohn’s disease is a rare, inflammatory bowel disease characterized by severe, chronic inflammation of the intestinal wall or any portion of the gastrointestinal tract. When Crohn’s is severe, the development of fistulas, obstructions, abscesses, or perforations frequently can necessitate the need for surgical resection of the bowel. Frequent surgical resections can result in loss of segments of the intestine and loss of sufficient absorptive capacity to maintain nutritional status.


Signs and symptoms of Crohn’s in pediatrics include:

  • Diarrhea (sometimes bloody, may lead to anemia)

  • Abdominal pain that is cramping in nature

  • Fever

  • Rectal bleeding

  • Poor linear growth and lack of adequate weight gain

  • Joint pain

It is not known what causes Crohn’s disease. It may be a virus or bacteria that affects the body’s infection-fighting system (immune system). Many children with Crohn’s disease have an abnormal immune system.


Diagnosis:

  • Blood tests to check for anemia, or blood loss. Your physician may also order tests to check white blood cells to assess your child’s immune response as well as inflammatory markers.


  • Stool culture to make sure there isn’t an infection by a parasite or bacteria causing the symptoms.


  • Endoscopy or colonoscopy to check inside the digestive tract and take a small biopsy of the intestinal tissue to look at the tissue under the microscope and confirm the diagnosis of Crohn’s disease.


  • Barium swallow or barium enema contrast study to observe the intestinal tract.

Treatment: The main goals of treatment include correcting nutritional problems, controlling the swelling and inflammation, easing the symptoms, and keeping complications from occurring. Depending on the severity your child’s Crohn’s disease will determine the course of treatment your physician will recommend. 


Certain diet modifications may be recommended or vitamins may be supplemented. 


Medications such as steroid, antibiotics, or immune-modulating medications may be utilized to help treat more severe cases. 


Surgical intervention may be required to drain abscesses, resect diseased intestine, or repair fistulas. In the case of extensive surgical resection and resulting short bowel syndrome, intestinal transplant may be indicated.