Pediatric IBD is a chronic inflammatory condition. A chronic condition does not mean that the disease is life threatening. It does mean that even with treatment to control your child’s symptoms, the disease will not go away. Because your child will have to manage the disease with various treatments throughout his or her life, it is important to know about what treatments are available and how they can help keep symptoms well-controlled.
Maintenance Care
Together with the treatment described above, all children with IBD need to continue a program of health maintenance. This includes:
The goal of treating your child’s Crohn’s disease is to help your child experience periods of remission, when your child feels no or only a few symptoms of the disease.
Right now, even with treatment, the disease will usually come back at different times during your child’s life.
Crohn’s disease is a chronic inflammatory condition that can affect any part of the digestive tract. A chronic condition does not mean that the disease is life threatening. It does mean that even with treatment to control your child’s symptoms, the disease will not go away.
Your child will have to manage their disease with various treatments throughout his or her life. And though there is no cure for Crohn’s disease yet, symptoms can usually be well controlled with proper treatment.
What are the treatments for Crohn’s disease?
Treatment of your child’s Crohn’s disease can include:
The goals of treatment are to:
Treatment of your child’s Crohn’s disease can depend on:
The goals of treatment will be different depending on if your child’s Crohn’s disease is active and flaring or if his or her symptoms are under control with treatment.
Induction Therapy
If your child is experiencing symptoms that are interrupting his or her daily activities and your child’s doctor has decided that treatment is needed, your child will begin induction therapy. The goal of induction therapy is to get your child’s inflammation under control as quickly, safely and effectively as possible.
Maintenance Therapy
Once induction therapy has helped your child’s disease into remission, or when his or her symptoms are much better, your child’s doctor will transition to maintenance therapy. The goal of maintenance therapy is to maintain or continue your child’s remission and to stop the disease symptoms from flaring again.
Drug Therapies
ANTI-INFLAMMATION DRUGS ACTIVE INGREDIENT – MESALAMINE
Most children with Crohn’s disease are first treated with drugs containing mesalamine, a substance that helps control inflammation such as:
The goal of anti-inflammation drugs is to control inflammation. Possible side effects of drugs with mesalamine in them can include: nausea, vomiting, heartburn, diarrhea, headache.
CORTISONE OR STEROIDS
(corticosteroids)
While being used less and less as more options become available, cortisone drugs and steroids, or corticosteroids, can be used when your child’s Crohn’s disease is flaring to get symptoms under control quickly. Corticosteroids are sometimes used for induction therapy. The dosage is lowered once symptoms have been controlled.
These drugs have serious side effects and are not to be used for the long-term management of your child’s Crohn’s disease. Prednisone is a common generic name of one of the drugs in this group of medications. Side effects of corticosteroids can include:
IMMUNE SYSTEM SUPPRESSORS
These drugs help to suppress your child’s immune system. The most common immune system suppressing drugs are:
Immunosuppressive agents work by blocking the immune reaction that causes inflammation.
At times, your child may be prescribed a combination of corticosteroids and immunosuppressive drugs.
Research suggests that immunosuppressive drugs may help corticosteroids to work better. If your child is treated with a combination of corticosteroids and immunosuppressive drugs, it is hoped that the dose of corticosteroids can be lowered in order to reduce the risk of your child becoming dependant on them.
Side effects of immunosuppressive drugs can include: nausea, vomiting, diarrhea, lowered resistance to infection, pancreatitis.
BIOLOGICS
Remicade, Humira, Cimzia, Simponi, Entyvio, Stelara, and other newer forms of biologic medications block certain parts of the body’s inflammation response. This is the newest form of treatment for Crohn’s disease.
ANTIBIOTICS
(ampicillin, cephalosporin, tetracycline, metronidazole, ciproflaxacin)
Antibiotics are used to treat bacteria in your child’s small intestine than can be caused by stricture, fistulas, or earlier surgery. Antibiotics may also change the bacteria in the intestine that might favor less inflammation and help intestinal healing.
ANTI-DIARRHEAL AND FLUID REPLACEMENTS
(diphenoxylate, loperamide)
Diarrhea, abdominal pain and cramping can get better when the inflammation is under control, but other medication may also be needed to keep these symptoms from coming back. If your child is dehydrated because of diarrhea, he or she can be treated with fluids and electrolytes. Antidiarrheal medications are not usually used in children due to concern about side effects.
Nutritional Therapies
Some children may decide to try strict nutritional treatment (using a formula) instead of medications. In many children with Crohn’s disease, this treatment can be as effective as the medications. If you are interested in this option, discuss this with the doctors and nurses taking care of your child.
If your child’s growth or development is slow, the doctor may recommend nutritional supplements. Special high-calorie drinks can be helpful in this case. A small number of children may need to be fed intravenously for a short time through a small tube inserted into the vein of the arm. This therapy can help children who need extra nutrition, those whose intestines need to rest, or those whose intestines cannot absorb enough nutrition from food.
Surgical Therapies
Many patients with Crohn’s disease have surgery at some point in their lives. Surgery may be considered by your child’s gastroenterologist if:
Surgery to remove part of the intestine can help children with Crohn’s disease, but it is not a cure.
Surgical Treatments
Surgical treatments for Crohn’s disease can include
which remove or shorten severely diseased or inflamed parts of the intestine and allow waste products to leave the body.
Each child is different, and not every surgical procedure is right for every child. Because a surgical treatment can affect your child and your family’s lifestyle significantly, it is very important to discuss your questions and concerns with your child’s medical team before the surgery. In some cases, you may have access to specialists such as an ostomy nurse or enterostomal therapist who has expertise and experience in counseling and caring for children and families before and after intestinal surgeries. Talking with other patients and parents who have been through surgery for similar problems can also be very helpful and reassuring. A good resource for more general questions or concerns is the United Ostomy Association.
The goal of treating your child’s ulcerative colitis is to help your child experience periods of remission, when they feel ono or only a few symptoms of the disease.
What are the treatments for ulcerative colitis?
Right now, even with treatment, the disease will usually come back at different times during your child’s life.
Ulcerative colitis is a chronic inflammatory condition of the colon. A chronic condition does not mean that the disease is life threatening. It does mean that, even with treatment to control your child’s symptoms, the disease will not go away. The one exception with ulcerative colitis is surgical removal of the entire colon, that will cure the disease.
Your child will have to manage their disease with various treatments throughout his or her life.
Though surgery can sometimes offer a cure for ulcerative colitis, symptoms can usually be well controlled with proper treatment.
Treatment of your child’s ulcerative colitis can include:
The goals of treatment are to:
Treatment of your child’s ulcerative colitis can depend on:
Though surgery can offer a cure for ulcerative colitis, symptoms can usually be well controlled with proper treatment.
The goals of treatment will be different depending on whether your child’s ulcerative colitis is active and flaring or if his or her symptoms are under control with treatment.
Induction Therapy
If your child is experiencing symptoms that are interrupting his or her daily activities and your child’s doctor has decided that treatment is needed, your child will begin induction therapy.
The goal of induction therapy is to get your child’s inflammation under control as quickly, safely and effectively as possible
Maintenance Therapy
Once induction therapy has helped your child’s disease into remission, or when his or her symptoms are much better, your child’s doctor will begin maintenance therapy.
The goal of maintenance therapy is to maintain or continue your child’s remission and to stop the disease symptoms from flaring again.
Drug Therapies
ANTI-INFLAMMATION DRUGS
ACTIVE INGREDIENT – MESALAMINE
Most children with ulcerative colitis are first treated with drugs containing mesalamine, a substance that helps control inflammation such as
The goal of anti-inflammation drugs is to control inflammation. Possible side effects of drugs with mesalamine in them can include nausea, vomiting, heartburn, diarrhea, headache.
CORTISONE OR STEROIDS
(corticosteroids)
While being used less and less as more options become available, cortisone drugs and steroids, or corticosteroids, can be used when your child’s ulcerative colitis is flaring to get symptoms under control quickly.
Corticosteroids are often used for induction therapy. The dosage is lowered once symptoms have been controlled.
These drugs have serious side effects and are not to be used for the long-term management of your child’s ulcerative colitis.
Prednisone is a common generic name of one of the drugs in this group of medications.
Side effects of corticosteroids can include:
IMMUNE SYSTEM SUPPRESSORS
These drugs help to suppress your child’s immune system. The most common immune system suppressing drugs are:
Immunosuppressive agents work by blocking the immune reaction that causes inflammation.
At times, your child may be prescribed a combination of
corticosteroids and immunosuppressive drugs.
Researchers find that immunosuppressive drugs may help corticosteroids to work better. If your child is treated with a combination of corticosteroids and immunosuppressive drugs, it is hoped that the dose of corticosteroids can be lowered in order to reduce the risk of your child becoming dependent on them.
Side effects of immunosuppressive drugs can include nausea, vomiting, diarrhea, lowered resistance to infection, pancreatitis.
ANTIBIOTICS
(ampicillin, cephalosporin, tetracycline, metronidazole, ciprofloxacin)
Antibiotics are used to treat toxic megacolon before the colon bursts.
ANTI-DIARRHEAL AND FLUID REPLACEMENTS
(diphenoxylate, loperamide)
Diarrhea, abdominal pain and cramps can get better when the inflammation is under control, but other medication may also be needed to keep these symptoms from coming back.
If your child is dehydrated because of diarrhea, he or she can be treated with fluids and electrolytes.
Nutritional Therapies
If your child’s growth or development is slow, the doctor may recommend nutritional supplements. Special high-calorie drinks can be helpful in this case.
A small number of children may need to be fed intravenously for a short time through a small tube inserted into the vein of the arm. This therapy can help children who need extra nutrition, those whose intestines need to rest, or those whose intestines cannot absorb enough nutrition from food.
Surgical Therapies
Almost half of patient’s with ulcerative colitis can have surgery at some point in their lives. Surgery may be considered by your child’s gastroenterologist if
Surgical treatments for ulcerative colitis can include a
this surgery is followed by one of the following surgical procedures
that allow waste products to leave the body.
Each child is different, and not every surgical procedure is right for every child. Because a surgical treatment can affect your child and your family’s lifestyle significantly, it is very important to discuss your questions and concerns with your child’s medical team before the surgery. In some cases, you may have access to specialists such as an ostomy nurse or enterostomal therapist who has expertise and experience in counseling and caring for children and families before and after intestinal surgeries. Talking with other patients and parents who have been through surgery for similar problems can also be very helpful and reassuring. A good resource for more general questions or concerns is the United Ostomy Association.