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Pediatric Inflammatory Bowel Disease (IBD)

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What is inflammatory bowel disease?

Pediatric inflammatory bowel disease (IBD) is a group of conditions that causes inflammation of the digestive tract. These conditions are chronic, but with our help, your child can manage the symptoms and achieve clinical remission.

What are the types of inflammatory bowel disease?

Your doctor may refer to these conditions as autoimmune diseases. That means that your child’s immune system has an abnormal reaction to the food and bacteria in the intestines and attacks the intestine’s cells. This attack creates chronic inflammation.

What causes inflammatory bowel disease?

Although the cause of IBD isn’t known, it is believed to be from a combination of genetic (inherited), immunologic and environmental factors.
 

How is inflammatory bowel disease diagnoses?

There are a number of tests that are used to diagnose inflammatory bowel disease. Your child’s doctor may use a combination of

  • A history and physical exam
  • Blood tests to check for anemia from blood loss and for an excess of white blood cells, which might indicate inflammation
  • Stool tests to look for blood in the stool and to rule out other types of infection
  • EGD or upper endoscopy, which uses a thin, flexible tube with a small camera attached to examine the esophagus, stomach and upper small intestine.
  • Colonoscopy, which uses a thin, flexible tube with a small camera attached to examine the entire colon, rectum, and ileum
  • Capsule endoscopy
  • CT scan, a noninvasive test that uses x-rays to create cross-sectional pictures of the body
  • Barium enema x-ray, a test that involves injecting a contrast medium, called barium, into the colon to make the colon, rectum, and lower part of the small intestine more visible on x-rays
  • MRI, an imaging test to visualize the small bowel without the use of radiation

The Gastroenterology Division’s Therapeutic Endoscopy Unit at Children’s Health is one of only a few facilities in the country that has developed a balloon procedure to be used in the diagnosis of small intestine conditions in children.

What is the treatment for inflammatory bowel disease?

Your child will be treated by a medical team composed of specialists in pediatric gastroenterology, nutrition, psychiatry, psychology, surgery, ostomy and wound healing, child life and social work.

Medication

Customary IBD treatment may include:

  • Anti-inflammatory medications
  • Corticosteroids
  • Immune system suppressors
  • Nutritional therapies
  • Biological therapies

Other measures

Your child’s doctor also may use:

  • Surgery to remove diseased portions of the digestive tract
  • Nutritional supplements, particularly for children whose growth has been slowed
  • Mind body biofeedback
  • Complementary and alternative medications

Resources

For more information on inflammatory bowel disease (IBD), refer to the following resources:

FAQs for Ostomy

Why is the pouch (bag) not sticking to my child’s skin?

There are many reasons that this may happen. If your child has grown since this pouching system was first used, your child may need the next size. If this is not the case then it may be due to the way you clean and prep the child’s skin before placement of the pouching system and/or failure to empty the pouch when it is 1/3 to ½ full of stool. Some skin care products will also affect the sticking of the pouch.

How long should a pouch last?

We would like an ileostomy pouch to last 1-2 days for an infant and 2-3 days for a bigger child. The pouch should be changed if there is leakage of the stool contents and/or the pouch is not adhering to the skin. When pouches have to be changed out more than once a day it should be addressed by one of the wound, ostomy and continence nurses in order to evaluate why this is occurring.

Why is my child’s skin red and moist around the stoma?

When you remove the pouching system wafer, look on the back and see if there is any damage to it. If so this means that leakage of stool got underneath the wafer causing the irritation and moisture. This may require that you change the pouching system more frequently or you may even need something to help it form a better seal such as an Eakins ring. Sometimes if the stoma doesn’t stick out far enough it is hard to get a good seal. The skin will need to be treated as well.

I don’t like the type of pouching system my child has, can I get something different?

While we only carry a small amount of different pouches at the hospital, we can sometimes order your child something different through the DME (supply) company. This may be limited depending on your child’s insurance. Many ostomy companies will send out free samples to try which is a good idea. This is helpful in determining the best product for your child before asking for the supply company to change the current order.

What do I do if I feel that I need more education on the care of my child’s ostomy?

Call our office to set up a time for additional training with our ostomy nurse. If your child is not an active patient in our office, then your child’s primary care doctor will need to send a referral.

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