About ¼ of all patients with chronic inflammatory bowel disease (CVD) are diagnosed in childhood and adolescence. Annually 800-1400 new cases of the disease are recorded. Doctors often prescribe aggressive treatment that impairs the quality of life of children.
What symptoms do children experience in their initial stages?
Young patients experience persistent diarrhea, abdominal pain, and medication. Children are more likely to develop more severe bowel inflammation and digestive upsets than adults.
Chronic inflammatory bowel disease significantly affects the quality of life of children.
Especially adolescents suffer from low self-esteem and are afraid of social isolation due to unpleasant symptoms. Frequent diarrhea, abdominal pain, and indigestion are the most common signs of an inflamed bowel.
Sick children are physically weaker than their peers and constantly suffer from fatigue. A disease can have a negative effect on mental abilities. Because of mental disorders, life prospects are constantly changing.
According to the Ministry of Health, the disease is often diagnosed at a late stage in children and adolescents. In case of untimely detected pathology, the risk of impaired development of bones, psyche and muscles increases.
How should children be treated?
A professional society requires that a multidisciplinary team of specialists take care of children and adolescents. It should consist of doctors, nurses, psychologists and nutritionists.
The short-term goal of drug therapy is to improve symptoms. It is important that children can return to the daily rhythm of life.
Medium and long-term goal is remission - the healing of the inflamed mucous membrane of the gastrointestinal tract.
Why is treatment different for adults and children?
Manifestations of inflammatory bowel disease vary significantly between children and adults. From 10 to 30% of young patients have growth disorders and mental retardation.
Treatment recommendations vary by age group. Recent researchers have summarized key tips in an American review article.
Especially in children and adolescents suffering from Crohn's disease, along with intestinal symptoms, growth retardation or puberty appears.
When diagnosed, the gastrointestinal tract in young patients is more often inflamed. Also, the disease progresses much faster than in adults.
Another difference is related to family history. In children, the most common cause of the disease is genetic disorders. If it is Crohn’s disease of any severity, meals are prescribed through a tube for 6-8 weeks at a young age. Following partial clinical nutrition, drug therapy with aminosalicylates is prescribed.
Other drugs - infliximab - are prescribed for medium and high disease activity. However, treatment with TNF-alpha blockers is not an alternative for adult patients.
Drug therapy in children continues until the end of puberty. Adults with Crohn's disease are advised not to smoke, but medications are not shown in all cases. The use of thiopurines to maintain remission in inflammatory bowel disease has a much higher priority in children and adolescents.
Methylprednisolone is used to treat severe acute ulcerative colitis in children and adolescents. TNF-α blockers (infliximab) are a supportive treatment option for patients with no response to thiopurin.
Children and adolescents with IBD are at increased risk of psychosocial problems and mental illness.
This can adversely affect school attendance, education, leisure and quality of life.
Case studies show that 25–40% of young patients have signs of clinical depression. Children require much longer and more thorough care than adults.
Previously, going to the doctor and identifying the disease play a decisive role in the recovery of the child. Parents should not ignore the symptoms of fatigue, indigestion, or diarrhea, as this is fraught with complications.
