Inflammatory Bowel Disease (IBD)

Inflammatory Bowel Disease (IBD) is a chronic inflammatory disorder of the intestines that does not have an identifiable cause (such as infection).  Currently, it is believed that inflammatory bowel disease arises because of dysregulation of the immune system.  The immune system in patients with IBD becomes inappropriately active, which results in injury to the intestine.  The common symptoms of inflammatory bowel disease include abdominal pain, diarrhea, rectal bleeding, and weight loss.


What are the types of inflammatory bowel disease?

There are 2 major types of inflammatory bowel disease: Crohn’s disease and ulcerative colitis.  Ulcerative colitis causes inflammation that is largely limited to the large intestine (the colon).  In contrast, Crohn’s disease can also affect other parts of the intestine, including the mouth, esophagus, stomach, small intestine and colon.  Most patients with Crohn’s however, have disease that affects the last part of the small intestine (terminal ileum) and the large intestine.  Crohn’s disease and ulcerative colitis are discussed in more detail in separate sections in GI kids.

In addition to the standard conditions of Crohn’s disease and ulcerative colitis, there are other less well understood types of inflammatory bowel disease.  These include inflammatory bowel disease that occurs in a J-pouch (pouchitis); inflammatory bowel disease that occurs in patients with immune deficiency; and inflammatory bowel disease that occurs in transplant patients.

Clinicians also utilize the term very early onset (VEO) inflammatory bowel disease to describe disease that occurs in children under the age of 6.  Many of these VEO patients have disease similar to the IBD seen in older children and adults, while others have more unique forms of IBD.

Some basic facts on inflammatory bowel disease

  • An estimated 1,000,000 Americans are living with IBD.
  • Nearly 1 in 4 patients diagnosed are under 20 years old.
  • The exact cause of IBD is unknown, but both genetic and environmental factors may be involved.
  • Patients with inflammatory bowel disease can also have inflammation in other parts of their body, including the skin, joints, eyes, or liver.
  • Inflammatory bowel disease (IBD) should not be confused with irritable bowel syndrome (IBS).  IBD patients are usually sicker, with diarrhea, abdominal pain, rectal bleeding and weight loss.  Colonoscopy usually will show evidence of inflammation that is confirmed on biopsy.  In contrast, irritable bowel syndrome (IBS) may cause abdominal pain and diarrhea, but usually the symptoms are milder.  In IBS, colonoscopy is normal.
  • Inflammatory bowel disease in children and young adults can often be managed effectively through medication or other treatments.  Treatment of inflammatory bowel disease requires close evaluation and follow-up by a pediatric gastroenterologist or inflammatory bowel disease specialist.  Treatment of inflammatory bowel disease involves a combination of medical and nutritional therapies.  In some patients, surgery may be necessary.

For additional information regarding specific medical treatments of IBD, please see the pages and GI kids on treating Crohn’s disease and ulcerative colitis.

North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
The Association of Pediatric Gastroenterology and Nutrition Nurses
North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Foundation
The NASPGHAN Council For Pediatric Nutrition Professionals
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