How Crohn’s Disease Affects Children

Crohn's disease is a recurring inflammatory disease that affects the lining of the gastrointestinal (GI) tract. This inflammation causes stomach pain, diarrhea, fatigue, weight loss, and difficulty absorbing nutrients from food.

Though Crohn's disease is more common in adults, the condition is increasing within the pediatric population. It affects about 10 out of every 100,000 children in the United States.

This article explores Crohn's disease in children and reviews its symptoms, risk factors, diagnosis, and treatment options.

What Is Crohn’s Disease? 

Crohn's disease is a chronic autoimmune disease of the GI tract that causes inflammation. The disease is one of several inflammatory bowel diseases (IBD).

Inflammation from Crohn's disease can occur anywhere along the GI tract, between the mouth and anus. However, it does not affect every part of the tract. There are healthy portions in between inflamed areas of the bowel.

There are five types of Crohn's disease. The type is based on where the inflammation occurs along the digestive tract, including:

• Ileocolitis: The most common type of Crohn's disease, ileocolitis affects the small intestine and large intestine (colon).
• Ileitis: Ileitis affects only the ileum, which is the end of the small intestine.
• Gastroduodenal: This type affects the stomach and the duodenum (the first portion of the small intestine).
• Jejunodeitis: This affects the jejunum, the upper part of the small intestine.
• Granulomatous: Granulomatous affects the colon and is also known as Crohn's colitis.

Symptoms of Crohn’s Disease in Children 

The most common symptoms that children diagnosed with Crohn's disease experience are:

• Diarrhea, including episodes of watery diarrhea
• Blood in the stool
• Abdominal pain
• Little desire to eat

Other symptoms that children may experience include:

• Urgency to have a bowel movement
• Loss of appetite
• Abdominal pain
• Weight loss
• Nausea
• Vomiting
• Exhaustion
• Malnutrition
• Fever and chills
• Blood in the stool
  

In some cases, the loss of appetite results in a reduced caloric intake and slow weight gain during childhood or adolescence. In severe cases of malnutrition, some children might grow more slowly than their friends or puberty may be delayed.

About 30% of children with Crohn's disease develop perianal disease, which is inflammation around the anus. This can be made worse by frequent bouts of diarrhea and cause tears or abscesses in the surrounding areas.

In very rare cases, children can develop Crohn's symptoms in areas outside of the GI tract. About 40% of children develop lesions, canker sores, or swelling in the mouth at some point.

Not every child with Crohn's disease experiences the same symptoms or severity of symptoms. In many cases, Crohn's will go through periods of remission and then return periodically.

Trauma, stress, or illness can trigger a flare-up. However, in many cases, symptoms can return for no unidentifiable reason.

If a child is experiencing Crohn's symptoms, speak with your pediatrician to understand their symptoms and develop a treatment plan.

Causes of Crohn’s Disease in Children 

The exact cause of Crohn's disease is unknown.

However, it is suspected that there is a genetic component. Crohn's disease can be hereditary, meaning it is passed down through families, and there are a number of gene mutations associated with Crohn's disease.

Crohn's could also be caused by a virus or bacteria that attacks the immune system. Some children with Crohn's disease have other immune system issues as well.

Who Is at Risk for Crohn's Disease?

It is not possible to predict who will get Crohn's disease.

The disease appears to affect boys and girls under the age of 17 equally, although there is some data to suggest boys may have a higher risk of developing Crohn's. One study found that girls appeared to develop more severe flare-ups, while boys were at a higher risk for developing growth failure.

Crohn's disease can affect people of all ages, but it is most commonly diagnosed in people in their 20s and 30s.

Children and teenagers may be at higher risk of Crohn's disease if:

• They are white.
• They smoke.
• They have a family history of Crohn's disease.
• They live in developed countries, in cities, and in northern climates.
  

How Is Crohn’s Disease in Children Diagnosed? 

Your pediatrician or other healthcare provider will conduct a physical exam and review your child’s medical history and symptoms. A doctor will use several different types of tests to diagnose Crohn's disease.

Noninvasive testing for Crohn's disease includes:

• Blood tests
• Stool cultures

Invasive diagnostic testing within the GI tract might include:

• Endoscopy (a nonsurgical procedure using a flexible tube with a light and camera to examine the GI tract)
• Colonoscopy (a nonsurgical procedure using a long, flexible tube to explore the large intestine)
• Biopsy (removing a sample of tissue for further examination in a lab)
• Barium swallow, or esophagram (an imaging test to examine the upper GI tract)
• Capsule endoscopy (procedure involving swallowing a small capsule containing a tiny camera in order to observe the small intestine)

There is no specific test for Crohn's disease or any other type of IBD. In most cases, a diagnosis of Crohn's disease will involve analyzing more than one diagnostic test.

How Is Crohn’s Disease Treated in Children? 

There is no known cure for Crohn’s disease. However, there are treatments and therapies available to manage symptoms and prevent flare-ups from occurring.

It is essential to speak with your healthcare provider about an appropriate treatment plan and follow their recommendations.

Crohn's disease patients may want to consider self-monitoring their food intake and avoid foods that cause pain or other symptoms.

Some other treatment guidance may include:

• Eat smaller, more frequent meals.
• Drink plenty of fluids.
• Avoid caffeine and alcohol.
• Take physician-recommended vitamins and supplements.
• Reduce intake of dairy, carbohydrates, and foods with excess fat.

Treatments for Crohn's disease for children experiencing a flare-up may include:

• Dietary changes
• Nutritional support if needed
• Medications, such as steroids that can reduce inflammation
• Intravenous (IV, though a vein) fluids or IV nutrition for children who are unable to eat

In some cases, your healthcare provider may recommend surgery. This will not cure Crohn's disease. However, it may fix some of the issues related to bleeding, an obstruction in the intestine, a hole or perforation in the bowel, or other symptoms.

Managing or eliminating symptoms is essential. In addition, your healthcare provider may discuss ways to help maintain normal growth, prevent complications, and maximize your child's overall quality of life.

A Word From Verywell

Having a child who is diagnosed with Crohn's disease can be overwhelming and worrying. Although there is no cure for Crohn's disease, there are many successful treatment options available. Many children live a full and happy life by managing their disease with a treatment plan that work best for them.