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Inflammatory bowel diseases (IBD)

Inflammatory bowel disease (IBD) refers to two diseases: Crohn's disease and ulcerative colitis. An estimated one million Americans live with IBD. Nearly one in four are diagnosed before the age of 20.

In both diseases there is ongoing abnormal inflammation in the intestine. Since 1999, doctors and scientists have come a long way toward better understanding IBD's causes. In patients with IBD, the body's immune system (the cells and hormones we use to fight infections) overreacts to the normal bacteria living in our intestines, causing inflammation and damage.

Ulcerative colitis

Ulcerative colitis is a form of IBD in which the inflammation is limited to the colon (also called the large intestine). In some patients, the inflammation only affects the last portion of the colon, close to the rectum. This is called "ulcerative proctitis." In other patients, the inflammation affects the entire colon, which is sometimes called "pancolitis."

Most patients with ulcerative colitis have bloody diarrhea, abdominal cramping, and a feeling of urgency, or little warning, when they need to have a bowel movement. Ulcerative colitis does not lead to the same complications as Crohn's disease. However, some patients lose a substantial amount of blood from ongoing intestinal bleeding. An estimated 520,000 people in the United States live with ulcerative colitis, 18,000 of whom are children.

Crohn's disease

Crohn's disease is a form of IBD in which inflammation can occur anywhere along the intestinal tract, from the mouth to the anus. The most common areas affected are the last part of the small intestine, called the terminal ileum, and the colon.

Because patients may have different areas of their intestine affected, the symptoms of Crohn's disease vary but can include abdominal pain, vomiting, diarrhea, blood in the stool, fatigue, weight loss, and growth failure. In some patients, the inflammation in Crohn's disease can be quite severe and lead to complications such as fistulas (inflammatory tunnels from the bowel to the skin or other organs), abscesses, or strictures (scarring and narrowing of the intestine).

An estimated 450,000 people in the United States live with Crohn's disease, 27,000 of whom are children.

What is the difference between IBD and IBS?

Inflammatory bowel disease (IBD) is often confused with irritable bowel syndrome (IBS) due to the similarities of the symptoms and names. They are very different conditions.

In IBS, patients have abdominal pain associated with altered bowel habits, either constipation or diarrhea, without any identifiable cause. The key difference between IBS and IBD is there is no increased intestinal inflammation in IBS. Therefore, patients with IBS are not at risk for long-term intestinal damage. Patients with IBS also generally do not have weight loss or blood in the stool, and have normal blood test results. While IBS is a less serious condition than IBD, it can still be very difficult for children and their families.

At Children's Hospital, our doctors in the Division of Pediatric Gastroenterology are also experts in diagnosing and treating IBS.

How did my child get IBD?

We still do not know the exact cause of IBD. If your child is diagnosed, it is important to know there is nothing you could have done to prevent your child from developing it. Some combination of a person's genes and environment sets off the intestinal inflammation in IBD. Approximately 10 to 25 percent of patients with IBD can identify a family member with IBD. However most patients have no family history of the disease. Since 2004, researchers have identified many genes associated with increased risk for developing IBD, but it is clear that no single gene causes the disease.

How we treat inflammatory bowel disease

At Children's Hospital, our top priority is to help children with IBD feel well and maintain normal growth so they can learn, have fun, and develop into healthy adults. With proper treatment, children with IBD should be able to lead normal lives. The vast majority of children with IBD can play sports, participate in activities, have fun with friends, and go to college.

IBD is a life-long diagnosis. Children with IBD should work closely with their doctor's team, learn about their disease, and take their medication regularly to avoid complications and stay healthy. At Children's, our goal is to educate children and their families so they feel in control of their IBD, and not that the disease is controlling them.

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