Crohn’s disease affects more than a half a million Americans, many who are diagnosed with the condition in their twenties and thirties. However, thirty percent of patients begin to see symptoms before their twenties, with approximately 100,000 teens and children in the U.S. currently suffering from Crohn's disease.
Crohn’s disease is an autoimmune disorder that affects the gastrointestinal tract, causing an inflammation that can result in excessive diarrhea, abdominal pain, and other symptoms. For adults, frequent trips to the bathroom can be an inconvenience, but for a young child dealing with peer pressure, this constant need for access to a toilet can be embarrassing.?
For a young person dealing with Crohn’s, conditions extend beyond the normal discomfort and pain of the disease. Children and teens are still going through puberty and, unfortunately, Crohn’s can stunt growth and weaken bones. It also can prevent a child from participating in activities with friends and classmates.
Treating Crohn's Disease in Children
For young people dealing with Crohn’s, it’s urgent to find a treatment that lessens symptoms without dangerous side effects. Some medications can be dangerous primarily to children. One preferred Crohn’s medication, Remicade, is known to cause a rare cancer in some patients. The cancer, called hepatosplenic T-cell lymphoma, can be fatal and is generally associated with the combination of Remicade and either azathioprine or 6-mercaptopurine.
Parents of children suffering from Crohn’s should attempt to learn as much as possible about the disease and find a way to explain it. The goal of the parent and the physician will likely be to treat Crohn’s with as few side effects as possible. A secondary goal is to find a way to manage the disease through diet, lifestyle changes, and a healthcare regimen that can be followed at home. Parents will also need to find a way to ensure the disease causes as little disruption as possible in a child’s daily routine.
Parents are often advised to refrain from serving high fiber or spicy foods. Dairy can be hard on digestion, as it can exacerbate symptoms. You may want to encourage your child to avoid foods with seeds, as well as nuts and popcorn. These foods can be difficult to digest and can block the intestine.
? Weak bones can be a symptom of some Crohn’s medications, so your child may be prescribed calcium supplements and one of the less harmful drugs for Crohn’s to keep side effects at a minimum.
Common Medical Therapies?
Aminosalicylates (5-ASAs) are similar to aspirin. Unlike aspirin, 5-ASAs can cut down on inflammation in Crohn’s disease. Since the inflammation in Crohn’s creates the most difficult symptoms, this can help children with minimal side effects. 5-ASAs do come with a few side effects: the most common are headaches, cramping and gas.
In less than 10 percent of those taking 5-ASAs, hair loss and skin rashes are reported. A few severe side effects are rare, occurring in less than one percent of those who take 5-ASAs. Those include a risk of dangerous inflammation in or around the heart, lungs, pancreas, kidneys, and a worsening of the inflammation the patient may already be suffering in the colon.
Antibiotics like metronidazole and ciprofloxacin are both prescribed in lighter doses for children. Metronidazole can cause reversible nerve damage if taken for long periods of time, and ciprofloxacin wasn’t approved in pre-pubescent children until recently.
Steroids in the form of corticosteroids are prescribed for some children, but many are uncomfortable with the side effects. Corticosteroids may cause acne, facial swelling, weight gain, and unwelcome hair growth. These side effects disappear as the physician lowers the dosage or takes the child off corticosteroids. Mood swings, personality changes, and high blood pressure can also result in children (and adults) taking corticosteroids.
Treating Crohn's in Children Through Nutrition
As many parents are wary of the potential side effects of most medications, nutrition and lifestyle changes may be the best options. While many cases of Crohn’s are too severe to resolve with mere dietary changes, ensuring that your child has a well-balanced diet can help reduce symptoms. Reducing dairy is often an option for adults, but it’s not generally recommended for children, as dairy is so important to children’s development.
Some families have successfully tried exclusive enteral nutrition (EEN), which involves an exclusive liquid diet specially formulated to combat ?inflammation. Many patients have found the formulas unpalatable, requiring some patients to have them administered via IV. While this is a safe method of combating Crohn’s, it’s largely inconvenient for many families.