How will my doctor diagnose my child with inflammatory bowel disease (IBD)?

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If you have approached your general practitioner with your child’s stomach problems, they may refer you to a paediatric gastroenterologist specialist. The paediatric gastroenterologist will take a careful history of your child and then give them a thorough physical examination (or order additional tests if your GP has already done this). Blood work to screen for UC and CD signifiers, such as:

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• increased white blood cell count

• low iron levels

• increased platelet count

• nonspecific inflammation markers (CRP, ESR)

• Stool inflammatory markers (faecal calprotectin)

• decreased blood levels of proteins (albumin)

• antibodies more commonly found in IBD patients

 

After the patient’s tests positive or negative for any symptoms, the specialist doctor will then interpret the blood tests to rule out or establish high suspicion of IBD.

A gastroscopy and colonoscopy will be done to confirm the diagnosis and to assess the extent and the degree of the inflammation.

In order to evaluate the full length of the small intestine, sometimes a Wireless capsule endoscopy or a special type of MRI (MR enterography) is performed.

 

How is inflammatory bowel disease (IBD) treated in children?

Treatment may vary according to diagnosis (Crohn’s vs Ulcerative colitis) the location and severity of the disease. The aim of the treatment is first to induce remission, meaning to lower the inflammatory response and then to maintain the achieved remission by keeping the body immune response less active.

 

Treatment may include

Diet (in Crohn’s disease- see below)

Oral or Intravenous corticosteroids

5-ASA/ Aminosalicylates – Mesalazine

Immunomodulators- Methotrexate or Azathioprine

Biologic Anti-TNF – Infliximab or Adalimumab.

Antibiotics

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How diet can help in treatment of Crohn’s disease?

 

Many studies have shown the link between specific food and the risk of developing Crohn’s Disease. For more than 20 years it is known that remission in mild-moderate Crohn’s disease can be achieved by 8 weeks of exclusive enteral nutrition (EEN). This diet is based on 100% intake of specific liquid formula. Although being very effective, EEN is difficult to follow and to maintain.  

 

Crohn’s Disease Exclusion Diet (CDED), is the first and only clinically proven therapy for the management of Crohn’s disease through whole food diet. The CDED therapy shown to induces remission in early mild-to-moderate CD in children and adults even without the need of other immunosuppression or modulation.

 

The CDED combines a whole food diet specially designed to help you gain control of Crohn’s disease, and a specific Partial Enteral Nutrition (PEN) formula to complete the caloric requirements.

 

As the CDED is based on whole food, it allows access to more variety of food to improve palatability and therefore more tolerated. It helps in maintaining remission and has no side effects.