Crohn’s disease can affect children as well as adults. In some ways, the condition is different in kids. While there’s no cure, treatment can help manage symptoms and maintain remission.

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Crohn’s disease is a condition that causes chronic inflammation in your digestive tract. Along with ulcerative colitis, it’s a type of inflammatory bowel disease (IBD).

Most people who receive a diagnosis of Crohn’s disease are between ages 20 and 30. But the condition can develop at any age, including in childhood.

Below, we’ll go over the details about Crohn’s in kids. We’ll cover topics like how it’s different, symptoms to be aware of, and how doctors diagnose and treat the condition in kids.

Here’s more in-depth information about Crohn’s disease.

While Crohn’s in kids happens due to the same inflammatory process that leads to the condition in adults, there are some differences in how this IBD affects children.

Effects on growth and development

The effects of Crohn’s disease interrupt the absorption of nutrients in the digestive tract. Additionally, symptoms like abdominal pain, diarrhea, and nausea can lower appetite.

Since kids with Crohn’s disease are still growing and developing, the condition can lead to delays in growth or puberty. In fact, many kids with Crohn’s receive a diagnosis after such delays are reported to a child’s doctor.

When developing a treatment plan for kids with Crohn’s, healthcare professionals must give special consideration to the potential effects of treatments on a child’s growth and development.

Subtypes and areas affected

A 2018 research review notes that most kids who receive a Crohn’s diagnosis are adolescents and that the condition’s progression in adolescents is often similar to how it develops in adults.

Yet two early onset subtypes of Crohn’s disease exist as well. One occurs prior to the age of 6 years, while the other occurs prior to the age of 2 years.

Crohn’s can affect any part of the digestive system. The areas most commonly affected are the end of the small intestine and the large intestine.

Research from 2013 found that this disease pattern is the most common in kids. Yet this research is older, and newer studies need to be done to confirm the finding.

Plus, early onset subtypes most often affect just the large intestine. They may also be more resistant to standard treatments.

Genetics

IBD in kids may also have more of a genetic component than IBD in adults. Researchers estimate that 19–41% of instances of IBD in kids are familial, compared with 5–10% in adults.

Some of the most common symptoms of Crohn’s disease in kids include:

Additional symptoms that kids with Crohn’s can experience may include:

Crohn’s causes chronic inflammation in the digestive tract. This leads to irritation and the symptoms of the condition.

But it’s still unclear what exactly causes Crohn’s disease itself to develop. Experts generally believe that several factors contribute:

  • Genetics: Crohn’s can run in families. Over 200 genes have been linked with IBD in general.
  • Autoimmune activity: An inappropriate immune response, such as a response to the bacteria naturally living in your digestive tract, may trigger the inflammation associated with Crohn’s disease.
  • Gut microbiota: An imbalance in gut microbiota, such as having too few beneficial bacteria and too many unbeneficial bacteria, may contribute to Crohn’s.
  • Environmental factors: Exposure to environmental factors may damage the digestive tract or stimulate the immune system in people genetically susceptible to Crohn’s disease. Examples may include exposure to certain:
    • infections
    • medications
    • toxins

In order to diagnose Crohn’s disease, your child’s doctor will first start by collecting your child’s medical history. They’ll also ask about your family medical history and whether other close relatives have received an IBD diagnosis.

The various tests that doctors use in the diagnosis of Crohn’s can include:

  • Blood tests: Blood tests check the levels of different types of blood cells. They can also look for signs of nutritional deficiencies or inflammation in the body.
  • Stool tests: Stool tests, like a stool culture, help to detect signs of inflammation or bleeding in the digestive tract. They can also help to rule out an infection as the cause of your child’s symptoms.
  • Imaging tests: Imaging tests can help a doctor see pictures of your child’s digestive tract and look for signs of inflammation or narrowing. Imaging tests that may be used are:
  • Endoscopy: Endoscopy uses a device to look at the inside of your child’s digestive tract. Some types also allow for a biopsy sample to be collected and analyzed. Endoscopy can be done in a few ways, such as by:

There’s no cure for Crohn’s disease. Instead, the goals of treatment are to:

  • manage Crohn’s symptoms
  • reach and maintain remission
  • ensure adequate growth and nutrition
  • prevent complications
  • improve quality of life

Each kid and each case of Crohn’s disease is different. Because of this, your child’s doctor will work to tailor your child’s treatment to fit their individual needs.

Prescription medications

Kids with Crohn’s often take prescription medications, which can include:

  • Aminosalicylates (ACAs): ACAs reduce inflammation and can be used in kids with mild to moderate Crohn’s disease.
  • Corticosteroids: Corticosteroids also reduce inflammation. Due to their side effects, they’re typically used on a short-term basis, such as to manage a Crohn’s flare.
  • Immunomodulators: Immunomodulators can suppress immune activity, lowering inflammation, and they may be used with ACAs that haven’t previously helped. Examples include:
  • Biologics: Biologics target specific steps in the inflammation process and can be used for moderate to severe disease. The Food and Drug Administration (FDA) has approved two biologics for kids with Crohn’s:
  • Antibiotics: Antibiotics may be used to treat infections or abscesses in kids with Crohn’s.

Dietary modifications and nutrition

Because Crohn’s disease can cause a narrowing of the intestine, your child’s doctor may recommend that they avoid eating foods that could lead to a blockage. A few examples include nuts, popcorn, and uncooked vegetables.

Additionally, some foods may make Crohn’s symptoms worse. These can vary by individual but often include milk, certain spices, and spicy foods.

Because the effects of Crohn’s disease can interfere with the absorption of nutrients, certain nutritional interventions may be necessary to ensure kids are getting adequate nutrition. This can include enteral nutrition delivered through a nasogastric tube.

Surgery

Surgery is typically recommended only when other treatments haven’t helped. Surgery often involves the removal of the affected part of the intestine.

A few things may increase a child’s risk of developing Crohn’s:

  • Genetics: Crohn’s can run in families, so if a close family member has the condition, this increases risk.
  • Sex: Crohn’s disease more often affects children assigned male at birth.
  • Location: IBD in kids is more common in developed countries, particularly North America and Northern Europe. It’s likely that environmental factors play a role in this.
  • Environmental exposures: A variety of environmental exposures have been linked with IBD in kids, including exposures to:

Crohn’s is a chronic disease. That means that it’s long-lasting and persistent. As such, people with Crohn’s will need to manage their symptoms throughout their life to help keep Crohn’s in remission.

In addition to the physical challenges associated with Crohn’s, the condition has other challenges for kids, who are still growing and developing physically, emotionally, and mentally. These can include:

  • feelings of sadness, stress, or frustration that can come with a Crohn’s diagnosis
  • discomfort or difficulty explaining their condition to peers
  • reduced self-esteem, potentially because of factors like reduced growth, delayed puberty, or more frequent trips to the bathroom
  • increased absences from school or other activities due to having a Crohn’s flare or attending doctor’s appointments

As such, it’s important to build a resilient support network for kids after a Crohn’s diagnosis. For some kids, meeting with a mental health professional may help them cope with the effects of Crohn’s disease.

While many people receive a diagnosis of Crohn’s disease as adults, the condition can also occur in children. There are several things that make Crohn’s in children different from Crohn’s in adults.

There’s no cure for the condition, but treatments can help manage symptoms, maintain remission, and ensure proper growth and nutrition for kids. Because Crohn’s is a chronic condition, it needs to be managed throughout an individual’s lifetime.