CDHNF's Webcast for Families Affected by IBD
Yesterday I had the privilege of listening in on the Children's Digestive Health and Nutrition Foundation's (CDHNF) webcast for families affected by IBD. I picked up a lot of useful information with regard to the way that IBD can affect children. I am going to share some of what I learned with you in this blog. If you would like to view the CDHNF's entire webcast check www.CDHNF.org. They will be posting the entire webcast in the next few days. I highly recommend viewing the 90 minute webcast when you have time! There were two physicians; Dr. Maria Oliva-Hemker and Joshua Korzenik; a registered dietitian, Jennifer Hampsey along with patients and families involved in the webcast. There were lots of wonderful slides and easy explanations to help with the "IBD learning curve".
Over 100,000 children in the US suffer from IBD according to the CDHNF webcast. Children diagnosed with IBD often have more severe symptoms. In UC, children tend to have the "pancolitis" form of the disease. Pancolitis simply means that the entire colon is inflamed as opposed to only a portion being affected. In Crohn's children tend to have the most involvement in the distal ileum and right side of the colon but also show more small intestine involvement than adults. Obviously, the more GI tract involvement in either disease the more severe it can be.
Another problem noted in children dealing with IBD is obtaining a quick and accurate diagnosis. Due to the fact that most children present with "abdominal pain" as the chief complaint it can be hard to narrow that down to IBD quickly. Obviously, there are many causes of abdominal pain in children and it can take 6-12 months or longer for most pediatric patients to obtain a diagnosis. Additional symptoms may include: low grade fever, joint pain, rashes, red eyes, mouth ulcers, inflammation in the bile duct or liver and delayed growth. Up to 30% of children with IBD may present with growth failure (both weight and height) as their main symptom. Again, if a child only presents with one or two of these symptoms it may delay diagnosis since some of these symptoms can be caused by several other illnesses.
Pediatric patients undergo most of the same testing and treatments as their adult IBD counterparts. Crohn's is more common in children than UC so doctors may be more likely to do both an upper endoscopy and colonoscopy. 5-Aminosalicylates, antibiotics, steroids, immunomodulators and biologic agents are all used in treating children with IBD. Children often have to start on the more moderate (instead of mild) treatments because they tend to have more GI involvement.
Dietary treatment should be well rounded and tailored to each individual person. Children with IBD should try to drink enough fluids, eat adequate amounts of protein, establish smaller more frequent meals if nausea is a problem. Limitation should only be placed on fiber and lactose if absolutely needed (during flares or with lactose intolerance) and a daily multi-vitamin is generally recommended in most instances. Most patients should be checked for nutritional deficiencies at least once a year or more frequently should they present with symptoms.
According to the webcast, the incidence of IBD in children is getting younger and younger and is being seen in areas of the world that didn't used to have IBD. About 7-10% of children are now being diagnosed at age 5 or below. Whether the changes in incidence of IBD is due to environment, diet or some other cause is unclear. What is clear is that we need to educate ourselves on the disease and its effects on our children in order to provide them with the best quality of life.
Tune in next month as I share with you information about talking with your child's doctor and school regarding IBD.