Inflammatory Bowel Disease in Children

Inflammatory bowel diseases affects your child’s digestive system by causing swelling (inflammation) in their intestines and other parts of their body. This can lead to abdominal (belly) pain, diarrhea and problems growing. While we don’t know the exact reasons why children develop IBD, an overactive immune system, genetics or the environment could be causes.

Crohn’s disease and ulcerative colitis are the most common types of IBD. Often, stomach cramps, diarrhea and gas are the first symptoms you’ll notice. These symptoms may come and go. Sometimes they’ll be mild. Other times, severe. They might come on gradually or suddenly.

IBD is a lifelong (chronic) condition. But the right treatments can help manage inflammation and symptoms. When your child has IBD symptoms, that’s called a “flare.” When they don’t have any, we call that “remission.” Our goal is to keep them in remission as often as possible. 

What to expect at your first visit

To help us find the best treatment for your child, we do a thorough physical exam, talk about their symptoms and go over their medical history at the first visit. We’ll also review any results from tests they’ve already had.

Next, we’ll ask your child how having IBD has affected their life. Do they worry about going to school? Is it hard to hang out with friends? How do they usually feel at home?

Understanding how IBD impacts your child’s life is a big step in making sure their treatment plan matches their unique health needs and goals. 

Diagnostic testing

We may also recommend one or more tests to figure out what type of IBD they have. A child life specialist visits with your child before any test. In age-appropriate language, they help your child understand the procedure and what they can expect so they’re less anxious.

There isn’t a single test to diagnoses any type of IBD. Instead, your child may have several different tests to help us confirm what’s been going on. These could include:

• Colonoscopy.
• EUS (endoscopic ultrasound).
• Flexible sigmoidoscopy.
• CT scan.
• MRI.
• Upper endoscopy.
• Wireless capsule endoscopy.
• Biopsy.
• Complete blood count.
• Stool (poop) tests.

Your child’s provider will go over their test results with you and answer your questions at a follow-up visit. They’ll use these results to create a care plan that helps your child feel better and have fewer symptoms.

Meet Our Pediatric Inflammatory Bowel Disease Team

At Cleveland Clinic Children’s, your child will have a team of healthcare providers who specialize in inflammatory bowel disease in children. They’ll support your child (and you) every step of the way — for as long as you need us. This care team could include:

• Pediatric gastroenterologists.
• Pediatric colorectal surgeons.
• Pediatric radiologists.
• Pathologists.
• Dietitians.
• Child psychologists.
• Social workers.
• Nurse care coordinators.

We’ll create a comprehensive, personalized plan focused on remission, controlling your child’s symptoms and helping them get back to doing the things they love. Remission includes improving symptoms, reducing inflammation in your child’s intestines and the return of normal growth.

Their treatment plan may include:

Annual IBD clinic visit

If your child is 12 or older, we may recommend they visit us once a year, regardless of their symptoms. During this annual visit, various members of their care team will meet with them to talk about how they’re feeling and if they’re having any problems.

Psychological support

Inflammatory bowel diseases in children can be stressful. Your child probably doesn’t feel great. They might worry about what they can and can’t eat. And chances are, they probably feel different from other kids.

Our pediatric mental health providers are here to help them work through the many emotions they may have. And we can help you manage your stress, too, as you support, encourage and care for your child.

Nutrition counseling

Nutrition plays a huge part in managing inflammatory bowel disease in children. Our team of registered dietitians, board-certified in pediatrics, will design a personalized diet for your child to help lessen flare-ups. We’ll also make sure your child gets the right nutrients so they can keep growing and developing.

Medications

Your child’s provider may recommend prescription or over-the-counter (OTC) medications to help control inflammation and encourage remission. These may include:

• Aminosalicylates to lessen irritation to their intestines.
• Antibiotics to treat infections.
• Biologics to reduce inflammation.
• Corticosteroids to manage flares.
• Immunomodulators to calm their immune system.

Your child can take some medicines by mouth, while other medications require an IV drip (infusion). We’ll keep an eye out for any side effects or reactions. And we’ll change dosages or medications as needed.

Surgery

Sometimes medications and diet changes aren’t enough to control your child’s IBD symptoms, and they may need surgery. Depending on what kind of IBD they have and how bad it is, your child’s provider may recommend:

• Colectomy (bowel resection surgery).
• Proctocolectomy (colon and rectum removal).
• Ileal pouch surgery.
• Ileostomy.

We’ll keep a close eye on your child during and after surgery and do everything we can to make sure they have a smooth recovery.

Lifelong care

Inflammatory bowel disease is a lifelong condition. You’ll want the best care for your child as they move into adulthood. Cleveland Clinic Children’s makes this as easy as possible. As your child grows, they’ll start seeing both their pediatric providers and new adult IBD providers at the same time.

This helps them move comfortably to adult care when they need it. We want to make sure we understand everything about their condition — how it’s progressed, what’s happened so far and what goals they have as they become an adult.

Taking the Next Step

When your child doesn’t feel right, you want the best care possible. From the moment you reach out to Cleveland Clinic Children’s, our healthcare providers do what it takes to help manage their inflammatory bowel disease. We’re here to answer your questions, listen to your concerns and find the right treatment for your child. And because IBD doesn’t go away when your child reaches adulthood, our care team is here to support them for life.