Children with Crohns Disease
When Dr Burrill Crohn first published his findings in 1932 on what was referred to then as Regional Ileitis, it was thought only to occur in adults with the most common age for this to appear being between the ages of 20 and 30 but, for no known reason, since the early 1970’s there has been a dramatic increase in the incidence of Crohn’s Disease in children of all ages and as yet there is no explanation for this continuing increase.
Crohn’s Disease is inflammation and ulceration of the digestive tract and can appear in one or more parts of the tract from the mouth to the anus. All children with Crohn’s Disease should be treated by a Paediatric Gastroenterologist or other specialist with extensive IBD experience.
Symptoms of Crohn’s Disease are extremely variable including severe pain (sometimes mistaken for appendicitis) vomiting, nausea, dramatic weight loss, persistent diarrhoea (possibly with blood and/or mucus) or constipation. Sometimes the symptoms may not suggest bowel disease at all with the child feeling lethargic with a loss of appetite, joint pains, skin rash or just growth failure.
These symptoms can appear very suddenly or in some cases very slowly with weeks or months of good health in between. As some of the symptoms mimic other less serious illnesses in children diagnosis can be difficult. Because of the intermittent and often vague nature of the symptoms the illness is sometimes thought to be caused by a virus before a diagnosis of Crohn’s disease is made.
A number of children with Crohn’s Disease have a striking delay in height and pubertal development. The cause is due to a combination of factors including the inflammatory process itself, loss of nutrients, steroid treatment and perhaps hormonal changes. Careful monitoring throughout the growing years and particularly during puberty is essential. With correct treatment some youngsters continue to grow in height into their twenties, long after the onset of puberty, and long after their peers have stopped growing. Many reach their normal height this way.
Oral Crohn’s, affecting the mouth and lips, occurs frequently in children and may occur with or without involvement of other parts of the digestive tract.
Support and understanding from parents, carers, family and friends is very important for children with Crohn’s Disease. CICRA publishes several leaflets to help families including a Parents Guide, a Teachers Guide a glossary of medical terms, fact sheets, newsletters and a book of stories titled ‘IBD & Me’, written by young people on how they cope with having a chronic condition. These can be obtained by becoming a member of CICRA (membership is free although donations are very welcome).