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Vital Signs
Special Attention for Children and Adolescents with IBD
Inflammatory bowel disease (IBD) is a chronic disease in which the body’s immune system attacks bacteria in the intestine, causing inflammation that can result in bleeding and diarrhea, abdominal pain, weight loss and poor growth in children. The two most common forms of IBD are Crohn’s disease and ulcerative colitis. IBD is a lifelong disease that can be controlled but not cured by medication, although cases of ulcerative colitis may be treated curatively by removing the colon.
Symptoms are often more severe in children than in adults, says David Ziring, M.D., director of UCLA’s Pediatric Inflammatory Bowel Disease Program, so medicines may need to be stronger to control symptoms. But the differences go well beyond the physical. “Children are not just small adults; they require different treatment,” Dr. Ziring explains. “IBD can affect the way bones grow, as well as how kids develop in terms of their relationships with peers and their success in school.” Adolescence is a particularly vulnerable period, when teens are first becoming independent and developing their self-image, Dr. Ziring notes. To be diagnosed with any chronic disease at such a time is difficult, but complicating matters from the psychosocial perspective is the nature of IBD — causing abdominal pain, diarrhea, bloody stools and the need to visit the bathroom frequently. “It’s not seen as socially acceptable to share this diagnosis with peers, and it can be embarrassing to constantly ask the teacher for permission to leave the classroom,” Dr. Ziring says. To deal with the diverse aspects of the disease, a multidisciplinary approach with a team, including a pediatric gastroenterologist, social worker/psychologist, nurse specialist and research coordinator, often is most effective.
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