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Paediatric Inflammatory Bowel Disease: Challenges and Management

Inflammatory Bowel Disease (IBD) is a chronic illness that produces swelling or inflammation in the intestines without any evidence of infection.

Varun Verma
Written by: Varun VermaUpdated at: May 20, 2023 02:30 IST
Paediatric Inflammatory Bowel Disease: Challenges and Management

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Inflammatory Bowel Disease (IBD) is a chronic illness that produces swelling or inflammation in the intestines without any evidence of infection, affecting people of all ages, including children. On this World Inflammatory Bowel Disease (IBD) Day, we talked to Dr Suresh Kumar Panuganti, Lead Consultant-Paediatric Critical Care and Paediatrics, Yashoda Hospitals Hyderabad to know more about paediatric IBD, its challenges, and management.

According to Dr Panuganti, "IBD involves two serious conditions called ulcerative colitis and Crohn's disease. While ulcerative colitis affects the lining of the large intestine, Crohn's disease can affect both the small and large intestines."

He said, "The onset of IBD is typically in early childhood or adolescence and tends to stay lifelong." This is known as Very Early-Onset IBD (VEO-IBD). To this, he added that this is a subset of IBD that affects children under the age of six. It is typically aggressive, more frequently has a genetic basis, and may require specialised treatments.

Inflammatory Bowel Disease Symptoms in Children

Dr Panuganti said that the degree of bowel involvement and the level of inflammation determine the symptoms. He added, "Children who have IBD frequently experience gut pain, full abdominal, loose stools containing blood and mucus, and even open rectal bleeding."

Other significant symptoms, according to the expert are failure to gain enough weight with time, intermittent fever, weight loss, and joint pain or swelling.

Also ReadWorld Inflammatory Bowel Disease Day: Differences Between Ulcerative Colitis And Crohn's Disease

Diagnosis of Inflammatory Bowel Disease In Children

Dr Panuganti said, "IBD in children is diagnosed by meticulously studying family and child's health history, clinical examination, blood tests, stool tests, imaging studies, endoscopy, and biopsy."

Challenges 

Dr Panuganti said, "IBD has long-term negative impacts on a child's growth, development, psycho-social function, and general well-being." He added that IBD can be brought on by the immune system, genetic, and environmental factors. 

He added, "Because of the nature of the studies needed for diagnosis and the absence of resources in the field, diagnosis is difficult in the paediatric age group."

How Likely is it for Siblings to Get Inflammatory Bowel Disease?

Dr Panuganti said, "IBD is more common in children who have a family member with it than in children without. However, this does not guarantee that they will develop the condition.”

Treatment of Inflammatory Bowel Disease in Children

Dr Panuganti said, "Depending on the location, severity, and whether your child has Crohn's disease or ulcerative colitis, the course of treatment will be decided." He added, "Although there is currently no cure for the condition, medication can help control the illness." 

He said that the purpose of treatment is to promote healthy growth and puberty, alleviate symptoms, manage dietary concerns, and minimise inflammation.

Also ReadInflammatory Bowel Disorders: Long-Term Complications To Watch Out For

"Medicines are used to alleviate symptoms, such as managing pain and inflammation, preventing immune system attacks that lead to inflammation, and optimise growth through vitamins and minerals," said Dr Panuganti.

He said that the majority of these medications must be taken for a long period of time. In some cases, children may also need surgery to alleviate the symptoms.

Nutrition and Vaccination

Dr Panuganti said, "The prompt diagnosis and compliance with treatment are two of the key issues associated with IBD in children." To this, he added, "The importance of nutrition cannot be overstated."

For someone with IBD, a conventional, balanced diet is ideal. "This implies that any meal from any food group, like fruits and vegetables, is acceptable for children to eat," added Dr Panuganti.

He added, "Although no one food has been proven to cause Crohn's disease or ulcerative colitis, some individuals may discover that certain meals, like fast foods, fat and greasy foods, can exacerbate their symptoms."

Talking about vaccines, Dr Panuganti said, "Although vaccinations can prevent young children from several infectious diseases, like chickenpox and measles, a child with IBD who is on immunosuppressive therapy should not receive live viral vaccines."

Conclusion

In the past few decades, developing nations have seen an increase in the incidence and prevalence of IBD, claimed research published in the journal BMJ. Dr Panuganti said, "Thus, to enhance the quality of life and avoid complications, IBD must be managed early, which includes early diagnosis and rapid medication. With proper therapy, a child can experience symptom-free periods for an extended period of time."

[Disclaimer: The information in this article is provided by a registered medical practitioner. However, we recommend you consult your healthcare provider for accurate diagnosis and treatment.]

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