Diagnosing IBD in Childrenby Jennifer Mitchell Wilson B.S. Dietetics, Dietitian, Health Professional
Children are one of the fastest growing groups of Inflammatory Bowel Disease (IBD) patients. It is unclear as to whether this is due to an actual increase in patients or better diagnostic procedures. Either way, if your child had IBD there can be a long period between the onset of symptoms and an accurate diagnosis. This is due to the fact that IBD symptoms can mimic many common childhood ailments, like stomach bugs, which leads to a delay in appropriate testing and treatment.
Some of the symptoms that children with IBD may exhibit are cramping and stomach pain, prolonged diarrhea, blood in the stool, and weight loss or failure to gain weight despite growth.
These symptoms may persist for a while and then go into compete remission, only to reappear again later. This can also make it especially hard to get an accurate diagnosis.
There are things that can put a child at an increased risk for IBD, which is why your child's physician will do a thorough history. If you have a family history of IBD or autoimmune disease it is important to mention this to your child's medical team. Children who are diagnosed with IBD before the age of 5 may also need to be tested for immune deficiencies. This can inform the doctors if a congenital (from birth) defect is causing the problem and help tailor appropriate treatments.
Some of the testing for IBD can include: blood tests for anemia, markers of inflammation or nutritional changes. The "gold standard" of testing is usually a colonoscopy with biopsy to study the tissue changes. Your child's physician may also want an endoscopy to evaluate the upper GI tract as well. In both of these tests a scope with a camera is placed to look for any damage and to biopsy tissue. It may be necessary to sedate your child in order for the doctor to complete these tests. This is usually done as an outpatient procedure.
Delays in Diagnosis
Many times pediatricians do not have IBD on their radar because it mimics so many other childhood ailments. These children can go for quite some time with out an accurate diagnosis. Delays in treatment only lead to additional issues with malnutrition, anemia, poor nutrient absorption or stunted growth. It also increases the risk that the disease will progress to the point where more serious damage has been done to the colon or intestine. Extended time with active disease is seen more frequently in children due to these issues.
How Caregivers Can Help
Children can have a difficult time with sadness or fears associated with IBD. They may be scared because they are in pain all of the time or because of the testing involved with obtaining an appropriate diagnosis. Explaining what will happen, age appropriately, before any test or procedure can help ease fears. Be careful not to label any discussions as "too gross" or you may find your child shutting down the lines of communication. Finding a support group for older children can also be a huge asset to their ability to cope.
While it can be quite scary to have your child diagnosed with IBD, it is also a huge step in the right direction. With the right diagnosis your child can begin to receive the treatments needed to feel better and prevent complications.