Inflammatory Bowel Disease (IBD)

The cause of IBD is still unknown. There is likely an interaction between a person's genetic makeup and their environment that triggers the disease process.

Crohn’s disease and ulcerative colitis affect different parts of the gastrointestinal tract. In Crohn's disease, any area of the digestive system—from the mouth to the anus—may be affected. In ulcerative colitis, only the large intestine (colon) is involved.

Symptoms of inflammatory bowel disease vary and may include:

• Abdominal pain
• Blood in the stool
• Delayed puberty
• Diarrhea
• Failure to thrive
• Fatigue
• Fever
• Joint pains
• Poor appetite
• Vomiting
• Weight loss

In a small number of children, the patient may clearly have inflammatory bowel disease, but physicians are unable to determine if Crohn's disease or ulcerative colitis is the cause. These children are diagnosed with indeterminate colitis. Gastroenterologists can often pinpoint the cause of the colitis and inflammation later in the child’s life.

Diagnosis of Inflammatory Bowel Disease

Your child's pediatric gastroenterologist may perform the following exams and tests to correctly diagnose inflammatory bowel disease:

• Blood tests. Blood tests are used to diagnose the condition and find out if your child has ulcerative colitis, Crohn's disease or indeterminate colitis. Examples of blood tests include complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), chemistry panel and inflammatory bowel disease antibody panel.
• Stool tests. Your child's doctor may order a stool test to see if there is blood in the stool and to find signs of inflammation and bacteria.
• Upper gastrointestinal (GI) endoscopy and colonoscopy. All children who are suspected to have ulcerative colitis or Crohn's disease will undergo both an upper gastrointestinal (GI) endoscopy and a colonoscopy. The upper GI endoscopy examines the esophagus (swallowing tube), stomach and upper small intestine. A colonoscopy examines the end of the small intestine and the entire large intestine. Your child will feel no pain or discomfort during these procedures, which are performed under general anesthesia.
• Imaging studies. Imaging studies that may be performed to diagnose inflammatory bowel disease include:
• Fluoroscopy. The doctor may perform a type of fluoroscopy procedure called small bowel barium X-ray. This study looks for disease in the areas of the small intestine which may not be reached and examined during the required endoscopy.
• Special imaging studies. The doctor may perform special imaging studies to look for problems with other organs (liver, pancreas, gallbladder, kidneys). An IV may be required. These tests should not be painful to your child. They include:
  • Ultrasound
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI)
• Capsule endoscopy. If a regular endoscopy does not allow the doctor to see all parts of the digestive tract that he or she needs to examine, capsule endoscopy may be used. Older children will be asked to swallow a capsule containing a camera that takes pictures throughout the small intestine while younger children will have the capsule placed by an endoscope. The capsule transmits a radio signal to a belt which is worn for eight hours following ingestion of the capsule.