Crohn's disease in children. Symptoms Diagnostics. Treatment. Drug therapy is the last hope

This disease affects the gastrointestinal tract. Crohn's disease occurs in 15 out of one hundred thousand children and is accompanied by pain and unpleasant symptoms.

Occurs in children of different ages, but is mainly affected by teenagers 12-18 years old. The child must be treated immediately. The sooner treatment begins, the faster the baby will recover.

Concept and characteristics

Experts define this disease as chronic, affecting the gastrointestinal tract.

Characterized by inflammation of its areas. In the early stages, the disease practically does not manifest itself.

Patients learn about the disease only in the later stages, when the disease has already cause serious harm to the body.

Most often, the disease occurs in adolescence: 12-18 years old, but there are cases when the disease is diagnosed in schoolchildren 7-10 years old. Young children suffer from this disease very rarely.

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Cause and risk group

The main reasons for the appearance diseases are:

past infections;
food poisoning;
genetic predisposition;
dysfunction of the immune system;
stress;
hormonal imbalance.

Doctors consider children in whose families there are cases of this disease to be at risk. According to experts, the disease can be transmitted from parents to children at the genetic level.

Classification

It is customary to classify the disease according to the location of inflammation. According to this division, the following forms are distinguished:

Ileocolitis. Painful areas are the ileum and colon.
Ileitis. Only the ileum is affected.
Colitis. The large intestine becomes ill, but the remaining sections remain healthy.
Gastroduodenitis. Inflammation occurs in the stomach and affects the duodenum.
Jejunoileitis. The focus of inflammation is observed in the ileum and small intestine.

Clinical picture

How does Crohn's disease manifest? Characterized by symptoms:

diarrhea;
stomach ache;
the child is not gaining weight;
increase in temperature;
secondary amenorrhea;
lack of appetite;
sleep disturbance;
the stool becomes voluminous, mucus with admixtures of pus appears.

Complications and consequences

If the disease is not treated, it may occur serious complications and consequences:

The appearance of abscesses.
Fistulas.
Intestinal perforation.
Peritonitis.

The inflammatory process can lead to narrowing of intestinal tissues, which negatively affects stool passage. As a result, constipation and intoxication of the body occur.

Why is it dangerous for infants?

In rare cases, the disease occurs in infants. It is difficult to treat the disease at such an early age, since not every medicine is suitable.

Usually in infants the disease manifests itself in the form of liquid stool with bloody discharge. The child has a stomach ache. Disease very dangerous for children of this age with complications:

Anemia.
Chronic digestive diseases.
Retarded growth and development.
Fistula formation.
Swelling of the folds of the anus.
Excessive thinness.

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Laboratory research and diagnostics

Diagnosis of the disease is carried out in the hospital through research:

blood, stool, urine tests;
colonoscopy;
radiography;
video capsule endoscopy;
fibrogastroduodenoscopy.

Differential diagnosis performed with intestinal diseases: acute intestinal obstruction, appendicitis, ulcerative colitis. Diagnosis in this case is extremely difficult, since most of the symptoms of the diseases are similar.

It happens that the final diagnosis is made only during surgery. Patients are often operated on with suspected intestinal obstruction and appendicitis.

Treatment methods

Depending on the development of the disease, various treatment methods are used.

Medication

It is effective only in the early stages of the disease, when fistulas and cracks in the intestines have not yet formed. Doctors prescribe medications:

Mesalazine;
Metronidazole;
Sulfasalazine;
Prednisolone.

Medicines fight harmful microorganisms in the intestines, eliminate inflammation, the consequences of poisoning, prevent the development of the disease.

Children need to take medication twice a day, one tablet for 2-3 weeks.

Surgical

It is used in the later stages of the disease, when medications do not bring the desired result. Half of the patients undergo more than one operation.

For children surgical intervention is prescribed for complications:

Severe intestinal bleeding.
Rupture of the intestinal walls.
Acute intestinal obstruction.
Fistulas.
Deep local damage to the intestine.

Objectives of the operation are:

Restoring the functioning of the damaged area.
Elimination of the source of inflammation.
Normalization of digestion.

After the operation, children are observed for two weeks in the hospital. For complete recovery of the body it may take three weeks, or in some cases a month.

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Whenever severe abdominal pain, bloating, constipation, diarrhea, you should consult a doctor. If the pain is very severe, you must call an ambulance.
While the ambulance is driving, the child is placed on the bed and given painkiller No-shpu in the amount of one tablet.
If the child has been examined and prescribed treatment, it must be strictly adhered to. Medicines are taken in the required dosage.
The patient should avoid heavy physical activity and require bed rest.
Complied with therapeutic diet, which is discussed with the attending physician.

For Crohn's disease in children.

Prognosis for recovery

Today, with proper treatment, it is possible to eliminate the unpleasant symptoms of the disease in a child in 2-3 weeks. in severe cases it will take one month. However, you need to understand that the problem may reappear if the child does not follow the doctors’ recommendations.

According to experts, the disease does not completely disappear; its symptoms appear again with severe poisoning, poor diet and decreased immunity.

To prevent the disease from developing, you need to take medications on time and visit your doctor regularly.

If you follow the instructions of doctors, the disease will not manifest itself, but the intestines will function correctly. The child will be able to lead a normal life, no different from his peers.

Prevention and diet

To prevent disease you need to follow some rules:

Maintain a healthy diet and eat only healthy foods.
Regular visits to a gastroenterologist.
Limiting physical activity.
The child should avoid increased stress in kindergarten and school.
Taking vitamins.
Walking in the fresh air.

Recommended for children follow a therapeutic diet. With its help, digestion will function correctly, gastrointestinal diseases will not occur, and there will be healthy microflora in the intestines. The menu must include:

vegetable soups;
porridge;
vegetables;
fruits;
fermented milk products;
lean varieties of meat and fish.

Should exclude from the diet:

baking;
sweet carbonated drinks;
chips and crackers;
fatty, fried foods.

Sweets are allowed only in limited quantities, not every day, but 2-3 times a week.

Therefore, this disease poses a huge danger to the child's body. To cure a child and eliminate the symptoms of the disease, it is recommended to begin treatment immediately, otherwise complications will arise that can only be dealt with surgically.

You can learn about what Crohn's disease is from the video:

We kindly ask you not to self-medicate. Make an appointment with a doctor!

Crohn's disease is a chronic progressive inflammatory disease of various parts of the digestive tract from the mouth to the anus. The essence of the pathology is inflammation of all layers of the intestinal wall, the formation of deep ulcers, in place of which granulomas then grow, narrowing the lumen of the affected part of the intestine.

The prevalence of the disease among the child population is 10-15 cases per 100 thousand children. In children, the disease can develop at any age, but children from 11 to 18 years of age are predominantly affected. There is practically no difference in the prevalence of the disease among boys and girls.

The final section of the small intestine is most often affected, which is why the disease is sometimes called “terminal ileitis.” In children, the jejunum and duodenum may be affected. Difficulties with early diagnosis of the disease lead to the spread of the pathological process to other parts of the gastrointestinal tract.

Reasons

Experts believe that the most likely cause of Crohn's disease is a failure in the immune system, resulting in the formation of antibodies to the cells of one's own body.

Scientists have not established the exact cause of the disease.

Possible reasons include:

infectious origin (bacterial or viral nature);
exposure to toxins;
psycho-emotional overload;
poor quality food;
side effects of certain medications;
adverse environmental influences.

Hereditary predisposition to the disease matters. But the largest number of supporters is with the immunogenic theory, according to which the occurrence of Crohn's disease is associated with a malfunction in the immune system and the formation of autoimmune antibodies against the body's own tissues.

It is possible that the development of Crohn's disease is associated not with one, but with a complex of causative factors, that is, any of them is a trigger for the occurrence of gene mutations and the development of the disease.

Classification

Depending on the prevalence of the process, Crohn's disease can occur in the form of:

terminal ileitis (damage to the small intestine);
colitis (the process is localized in the large intestine);
ileocolitis (both the small and large intestines are involved in the process);
anorectal (predominantly affecting the anus and rectum).

The course of the disease is undulating, with alternating periods of exacerbation and remission.

Symptoms

In children, Crohn's disease may be hidden for some period, almost asymptomatic, or masked behind extraintestinal manifestations. This latent period can last up to 3 years, which makes timely diagnosis of the pathology difficult. But then the disease still manifests itself.

Clinical signs of Crohn's disease are varied:

Persistent diarrhea up to 10 bowel movements per day. The frequency and volume of stool depend on the level of damage to the digestive tract: the higher the affected area is located, the stronger the diarrhea. Blood may occasionally be present in the stool. When the small intestine is damaged, the absorption of nutrients is impaired - malabsorption syndrome develops. This leads to loss of body weight. In babies, stool may become profuse, mixed with mucus, pus, and light in color.
All children experience abdominal pain. At the initial stages, they can be insignificant and unstable, and as the disease progresses they become strong, cramping, accompanying food intake and acts of defecation. The cause of pain is a narrowing of the intestinal lumen, making it difficult for food to pass through.
Often the pain is accompanied by flatulence (bloating).
When the gastric mucosa is damaged, the child experiences nausea, a feeling of heaviness in the epigastric region, and vomiting.
Temperature increase within 37.5 ° C, general weakness, lack of appetite.

With total damage to the intestines, the disease may manifest itself in the form of a symptom complex characteristic of an “acute abdomen” when children are admitted to the surgical department.

Extraintestinal symptoms of Crohn's disease are manifested by lesions:

joints in the form of monoarthritis (inflammation of one of the joints) and arthralgia (pain in the joints);
oral mucosa – aphthous stomatitis;
eye – uveitis, iridocyclitis, episcleritis (inflammation of the membranes of the eye);
biliary tract – cholestasis (stagnation of bile), cholangitis (inflammation of the bile ducts).

As a result of impaired absorption in the intestines, hypovitaminosis develops, deficiency of microelements (, etc.), and the electrolyte composition of the blood is disrupted. As a result of a lack of proteins in the body, edema appears. Vascular disorders are possible.

Features of the course of Crohn's disease in children are significant developmental delay (physical and sexual), increased temperature to high levels, and severe joint pain. In girls, the menstrual cycle is disrupted (secondary amenorrhea is noted).

Of the extraintestinal manifestations of the disease, children most often develop damage to the eyes, oral mucosa and skin in the form of eczema, dermatitis, and long-term non-healing ulcers.

Complications

The most significant symptoms of Crohn's disease in children are abdominal pain and frequent (up to 10 times a day or more) loose stools.

In Crohn's disease, complications are often associated with severe intestinal damage. Anal fissures, perianal abscesses, and fistulas often occur. Due to a sharp narrowing of the intestinal lumen, intestinal obstruction may develop. Perforation (perforation of the wall) of the intestine and the development of an inflammatory process of the peritoneum (peritonitis) cannot be ruled out. The lumen of the small intestine may become pathologically dilated (toxic dilatation).

Diagnostics

In addition to interviewing the child and parents and examining the patient, the results of laboratory and instrumental studies are important for diagnosing Crohn’s disease.

Clinical and biochemical blood tests in Crohn's disease reveal the following changes:

decrease in hemoglobin, red blood cells and reticulocytes (young cells, precursors of red blood cells);
increase in the number of leukocytes;
accelerated ESR;
hypoproteinemia (decrease in total protein in the blood);
violation of the ratio of protein fractions (decreased albumin and increased alpha globulin);
increased alkaline phosphatase activity;
the appearance of C-reactive protein;
decrease in the content of potassium and other trace elements.

The severity of changes in biochemical parameters corresponds to the severity of the disease.

A coprogram and stool analysis for dysbacteriosis, and stool culture for pathogenic microflora are also prescribed to exclude another cause of diarrhea.

An endoscopic examination of the intestine is mandatory - colonoscopy (examination of the intestine from the inside using a flexible endoscope equipped with fiber optics and a microcamera).

Endoscopic changes in the mucosa can vary depending on the extent of intestinal damage and stage.

According to the endoscopic picture, the following phases of Crohn's disease are distinguished:

The infiltration phase, in which inflammation invades the submucosal layer of the intestinal wall. In this case, the mucous membrane has a matte surface, the vascular pattern is not visible. Small erosions resembling aphthae with a fibrinous coating may be detected.
The ulcer-fissure phase is characterized by the appearance of individual or multiple deep ulcers (involving the muscular layer of the intestinal wall). Cracks in the mucous membrane intersect with each other, creating a “cobblestone street” picture. The intestinal lumen in the affected area is narrowed due to pronounced edema not only of the submucosal layer of the intestinal wall, but also of its deep layers.
The scarring phase is characterized by the presence of granulomas and the formation of an irreversible narrowing of the intestinal lumen.

During endoscopy, material is taken for biopsy - its histological examination allows to confirm the diagnosis.

When X-ray examination (with double contrast), characteristic signs of Crohn's disease are segmental lesions of the intestine, uneven, wavy contours. Ulcers may be found in the colon. Haustration (ring-shaped protrusions of the wall of the large intestine) below the lesion segment is preserved.

CT, MRI, ultrasound, and immunological studies can also be used.

Crohn's disease must be differentiated from a protracted course of intestinal infection, malabsorption syndrome, and intestinal tumors. It also has many similar manifestations to Crohn's disease. But there are also differences. With Crohn's disease, the pain syndrome is more pronounced, but there is less blood in the stool, there are no painful spasms during defecation, the rectum is less often affected, and the volume of feces during bowel movements is more abundant.

Treatment

The intestinal mucosa in this pathology resembles a “cobblestone street.”

For Crohn's disease, conservative and surgical treatment is used. During the period of exacerbation, children are hospitalized in the gastroenterology department and are prescribed bed rest. Outside of exacerbation, a gentle regimen with minimal physical activity is recommended.

Conservative treatment is selected individually, taking into account the age of the child and the severity of the disease. Treatment is aimed at suppressing inflammation and eliminating intoxication, transferring the disease into remission.

The components of complex conservative treatment are:

diet therapy;
use of 5-aminosalicylic acid derivatives;
antibiotic therapy;
corticosteroid drugs (for severe forms of the disease);
probiotics;
enterosorbents;
enzyme preparations;
vitamin and mineral complexes;
iron supplements (with ).

Diet therapy

In the acute phase of the disease, the diet corresponds to table No. 1 according to Pevzner. In case of severe exacerbation, a semi-starvation diet may be prescribed for 1-2 days: it is allowed to drink acidophilus milk, low-fat kefir, slightly sweetened tea, grated or baked apple.

You need to feed your baby in small portions 5-6 times a day. Food should be pureed and warm. As the exacerbation subsides, new products are gradually introduced with the permission of the attending physician, and the child is transferred to table No. 4 according to Pevzner.

Dishes are prepared by boiling, baking or steaming. The ratio of proteins, carbohydrates and fats, the volume of meals and liquid consumed per day is calculated by the doctor depending on the age of the child.

Allowed:

pureed mucous soups in a second broth (meat or fish);
mashed in water (except millet, buckwheat, pearl barley, corn);
e puree;
chicken and rabbit meat in the form of soufflé or minced meat, steamed meatballs (without seasonings or gravy);
crackers (from white bread);
mashed (or in the form of casseroles);
steam omelette;
jelly and jelly (from blueberries, bird cherry, pears).

Stewed vegetables (cauliflower), small noodles, low-fat fermented milk products, mild cheese (preferably grated) are gradually introduced. Casseroles should not have a crispy crust. A new product is introduced every three days and the child’s condition is monitored. If pain, bloating or diarrhea occurs, the irritant is excluded from the diet. Another product is then introduced no earlier than 3-5 days later. Any expansion of the diet must be agreed with a doctor.

The following should be excluded from the diet:

fatty meat (lamb, pork, goose, duck);
sausages;
fish and meat, canned vegetables;
smoked;
pickle, okroshka;
milk soup;
raw vegetables;
, radish, horseradish, radish, ;
legumes;
sour berries;
grape juice;
ice cream;
chocolate.

The consumption of sweets should be minimal.

Drug therapy

Among antibiotics, broad-spectrum drugs and antibacterial agents (Metronidazole) are used. The most pronounced effect is obtained when prescribing 5-aminosalicylic acid drugs (Sulfasalazine, Mesalazine, etc.).

In the acute phase, corticosteroids (Dexamethasone, Prednisolone, Hydrocortisone) are used in severe cases. In rare cases, cytostatics are used (Cyclosporine, Azathioprine).

In severe cases of the disease, severe electrolyte imbalances and the development of hypoproteinemia (severe protein deficiency in the body), intravenous drips of electrolyte solutions, plasma, amino acid solutions, and albumin are used.

To improve food digestion, enzyme preparations (Pancreatin, Creon, etc.) are used. To restore microflora imbalance, probiotics (Bifidumbacterin, Bifiform, Bifikol, etc.) are prescribed. Enterosorbents (Smecta, Enterosgel) are prescribed as symptomatic treatment.

Surgical treatment

If complications develop, surgical treatment is performed - the affected area of the intestine is removed, its patency is restored by performing an anastomosis, and the fistulas are excised. But, unfortunately, surgery will not protect against the development of relapse of the disease.

Prevention

It is difficult to prevent the occurrence of Crohn's disease without knowing the exact cause of its development. Acute intestinal infections should be prevented or treated correctly. It is important to strengthen the child’s immunity, eliminate psychological trauma, and ensure regular medical supervision of the child’s development. If Crohn's disease occurs, every effort should be made to prevent exacerbations.

Forecast

It is impossible to cure a child from Crohn's disease. With proper and persistent treatment, remission can be achieved, sometimes long-term, improving the child’s quality of life. The prognosis for life depends on the severity of the disease and the complications that develop.

Summary for parents

Crohn's disease is a serious and incurable disease. Attentive attention to the child’s health and regular doctor’s supervision will help prevent the severe development of the disease. Lifelong adherence to the diet and treatment under the supervision of a gastroenterologist will ease the course of the disease and put it into remission.

Crohn's disease is a pathology characterized by ulcerative inflammation of various parts of the intestine. Until recently, this chronic disease was considered a problem for adults, but over the years it has rapidly become “younger.” Today, children under 7 years of age are increasingly becoming victims of Crohn's disease, or progressive ileitis.

An experienced specialist should diagnose Crohn's disease and prescribe treatment for the disease.

Causes of the disease and phases of its course

Inflammation of the gastrointestinal tract, later called Crohn's disease, was first recorded in 1932. Then doctors were unable to identify the reasons for the development of the pathology, and today doctors only have assumptions about this. Risk factors for the child are:

genetic predisposition;
autoimmune disorders;
intestinal dysbiosis.

The impetus for the occurrence of inflammation is external unfavorable conditions. The leading ones among them are poor nutrition, stress and the child becoming infected with a viral infection.

In children, Crohn's disease occurs in several phases:

infiltration – inflammation is localized in the submucous membranes, provoking the development of small erosions;
the formation of ulcers-cracks - the muscle tissue of the intestine is destroyed, which causes severe swelling that impedes patency;
scarring - erosion leads to the formation of irregularities in the large intestine, as a result of which the stenosis becomes chronic.

Characteristic symptoms of Crohn's disease

Crohn's disease is classified as nonspecific. Its clinical picture and symptoms in children are incredibly varied, which greatly complicates the diagnostic process.

However, certain signs of the disease in young children are considered characteristic:

frequent bowel movements;
weight loss;
abdominal pain, localized depending on the location of the source of inflammation;
constantly elevated temperature.

It is worth paying attention to symptoms such as anemia, inflammation of the mucous membranes of the mouth, joint pain and severe fatigue. Crohn's disease in young children is often accompanied by some of these uncharacteristic manifestations.

Treatment methods

Despite the achievements of modern medicine, childhood Crohn's disease is difficult to treat, but if the pathology is detected in time thanks to a general blood test, there is a high chance of developing an effective control strategy.

Treatment is comprehensive and includes:

diet;
taking medications;
if necessary, surgery.

Use of medications

To relieve the symptoms of Crohn's disease, antibiotics (Metronidazole), enzymes (Pancreatin), and sorbents (Smecta) are prescribed. The action of such drugs is aimed at suppressing the pathogenic activity of the patient’s immune system. Children are prescribed individual treatment in the form of small doses of glucocorticosteroid drugs, for example, Prednisolone, and additionally require folic acid and multivitamins (always with vitamin B12).

Diet

Dietary restrictions for children not only serve as an effective prevention of Crohn's disease, but also help fight the symptoms of inflammation that has already begun.

The menu of a child with Crohn's disease should include a large amount of fish and seafood

Features of the therapeutic diet are as follows:

eating large amounts of seafood;
avoidance of foods high in lactose and gluten;
reducing the fat content of consumed meat products;
compliance with food calorie standards.

Surgical intervention

If conservative therapy is ineffective, the pathology site is removed surgically. In addition to excision of the affected tissue, the surgeon’s task in this case is to restore intestinal patency by performing an anastomosis.

It is worth noting that even such an operation does not provide insurance against recurrence of Crohn’s disease in a child. Therefore, complex surgical treatment is usually not prescribed to young patients.

Crohn's disease in children is difficult to treat. This pathology is inflammatory-autoimmune. The process affects all layers and tissues of the esophagus, focally manifesting itself in any part of the gastrointestinal tract. The inflammatory process is chronic, with periods of exacerbations and remissions. With improper treatment, complications develop - from suppuration and unnatural canals to rupture of the digestive tube with subsequent inflammation of the peritoneum. It is treated both medicinally and surgically.

Description of the pathology

Crohn's disease is a chronic inflammation of an autoimmune nature. The disease, despite its chronicity, rapidly progresses; in the process of inflammation, a nodular modification of the inner surface of the walls of the esophagus and the final section of the small intestine, and less often the stomach, occurs. Foci form in other parts of the gastrointestinal tract. Due to the loss of immunity to pathogens, uncontrolled inflammation develops.

Most teenagers aged 12-18 years suffer from Crohn's disease. Cases of the disease appearing in children under 7 years of age have been recorded.
Violation of the intestinal microflora provokes attacks of severe pain.
Over a long period of time, the lumen of the affected organ narrows, making it difficult for food to pass through. The baby complains of pain, increased bowel movements due to lack of neuromuscular coordination in the intestinal walls, and microflora disturbances. The inflamed mucous membrane does not absorb water and electrolytes in the required volume. Particularly severe cases are considered to be those when children have multiple foci of nodular changes in the walls in the hollow organs of the gastrointestinal tract.
The difficulty in treating Crohn's disease lies in the difficulty of diagnosis due to its latent form with symptoms hidden under other ailments. The latent phase lasts from a couple of months to 3 years. In the absence or untimely treatment, inflammation affects all parts of the child’s gastrointestinal tract, aggravating the clinical picture and, accordingly, treatment. The disease is characterized by alternating acute periods with phases of calm symptoms.

Predisposition
The causes of Crohn's disease in children are not fully understood. There is a predisposition (it varies among children). The risk increases if the baby has:
Burdened with genetics, that is, one of the relatives already suffers from this disease.
Microbacteria that are similar in structure to Koch's bacillus (the causative agent of tuberculosis).
Violation of the quantitative and qualitative composition of beneficial microbacteria, which affects the state of the immune system.
Incorrect diet and poor quality food.

Phases of the disease
In children, Crohn's disease develops in 3 phases:
Infiltration. This period is characterized by localization of inflammation in the submucosal layer. Visually, the inflamed area is matte without a vascular pattern. Subsequently, the mucous membrane becomes covered with wounds (superficial erosions, deep aphthae) with fibrin inclusions - special blood plasma proteins that keep toxins from spreading.
Formation of ulcers and cracks. The deepening of the wounds reaches the muscular layer of the intestinal or esophageal wall of the child. The ulcers are connected by cracks, the mucous membrane swells, which leads to a narrowing of the lumen.
Scarring. As the ulcers heal, rough connective tissue is formed, the growth of which causes irreversible stenosis (narrowing) of the intestine. At this stage, areas of ulceration and irregularities form in the colon.

Symptoms of Crohn's disease in children
Frequent bowel movements are a characteristic symptom of all types of Crohn's disease.
Symptoms of childhood Crohn's disease depend on the location of the main localization of the pathological process in the gastrointestinal tract. According to research, 50% of all children suffer from nodular inflammation of the cecum and ileum (ileocecal type), less often - from small intestinal pathology, and even less often - from the colon form. Rare types of the disease affecting the oral cavity, esophagus or stomach occur in 5% of children.
The general clinical picture, characteristic of all types of Crohn's disease in children, includes the following symptoms:
frequent bowel movements - up to 10 times per day;
a sharp decrease in body weight against the background of impaired intestinal absorption;
pain in different areas of the abdomen, depending on the location of the problem;
subfebrile condition - body temperature 37.5°C degrees.

If intestinal absorption is impaired, a deficiency of vitamin B12, which is involved in hematopoiesis, develops. Therefore, children experience varying degrees of anemia. The ileocecal form often occurs like inflammation of the appendix with increasing pain in the lateral abdomen. Symptoms of fever develop with an increase in the level of white blood cells in the blood.
When the entire colon is affected, the pain in children is cramping and appears after a meal and before bowel movement. Blood is visible in the stool. The protracted form of Crohn's disease in children is characterized by the appearance of extraintestinal symptoms, such as:
aches in the joints and spine;
inflammation of the mucous membrane of the eyes;
skin lesions in the form of erythema nodosum;
aphthous stomatitis.

Frequent, loose and profuse stools provoke the development of corresponding symptoms in the form of:
irritated skin and mucous membrane around the anus;
swelling of the folds of the anus;
cracking, ulceration;
formation of fistulas (unnatural, hollow passages).

The initial stage of the disease in infants is accompanied by the presence of blood in the stool.
In babies of the first year of life, the first stages of the disease are manifested by diarrhea with bloody inclusions. With a prolonged course, there is a lag in development and growth. A 1-3 year old child has stunted growth, does not gain weight, and has constant abdominal pain and chronic diarrhea. In children 3-7 years old, pain and diarrhea immediately appear, then extraintestinal symptoms are added. In older children (7-10 years old), stunted growth, excessive thinness, and chronic pain with periodic increases are noticeable. A typical symptom for a sick teenager is frequent fevers.

Types of diagnostics
In order to determine the state of the body and the degree of inflammation, clinical blood tests and biochemistry are prescribed. Mandatory diagnostic procedures are:
Laboratory tests of biofluids - blood, urine, feces.
Specific blood tests for antibodies.
Hardware and instrumental techniques necessary to assess the state of the gastrointestinal tract and identify foci of inflammation:
radiography with contrast of the small and large intestines (the method is especially important when examining children with retarded growth, development, and puberty);
colonoscopy with biopsy (the method is indicated for diarrhea with blood);
video capsule endoscopy - for assessing the entire gastrointestinal tract in real time;
fibrogastroduodenoscopy - for examining and removing suspicious tissue from the upper gastrointestinal tract.

Treatment
The therapeutic regimen is comprehensive and includes:
supporting nutritious nutrition bypassing the intestines;
medication treatment regimen;
psychological consultations;
surgery (if necessary).

Drug therapy
Drug therapy should be carried out exclusively under the supervision of a doctor.
The drugs “Sulfasalazine” with “Mesalazine” are the most effective for Crohn’s disease in children. Additionally, folic acid and multivitamins are prescribed (always with iron and vitamin B12). At the acute stage and in case of severe complications, treatment is carried out with glucocorticoids (Prednisolone, Hydrocortisone, Dexamethasone), immunosuppressants (Cyclosporine, Azathioprine). Broad-spectrum antibiotics (Metronidazole), probiotics and enzymes (Pancreatin), antidiarrheal drugs and sorbents (Smecta, enterosorbents), painkillers and antispasmodics are used as symptomatic therapy.
Any self-medication is prohibited. Even painkillers for the child are agreed upon with the doctor. The doctor develops the dose and course of treatment individually for each patient.

If a child complains of abdominal pain, has an elevated body temperature for a long time, changes in stool and weight loss, you should immediately contact a pediatrician. It could be Crohn's disease.

What is this?

Crohn's disease is a chronic disease of the digestive system in which the tissues of the intestines and other parts of the gastrointestinal tract become inflamed and destroyed. The name of this disease was given by one of the doctors who described it in 1932. The onset of the disease is possible at any age, but most often it is detected in people from 13 to 30 years old.

Although the pathology is quite severe and serious, many people who have Crohn's disease who receive adequate treatment live a long time and lead almost normal lives. Most often, the course of the disease occurs with exacerbations (in most patients they occur every two years or less) and remissions.

Reasons

At the moment, scientists have not yet found the exact causes of Crohn's disease. At the same time, the role of heredity is noted, since in direct relatives of patients the incidence of the disease is 5-20 times higher. If a parent has Crohn's disease, the child has a 5% chance of having the disease.

Other factors contributing to the development of this pathology include infection with viruses or mycobacteria, ingestion of toxins, certain medications, and the influence of food.

Development of the disease

With this disease, foci of inflammation appear in the walls of the digestive tract. Most often they occur in the ileum and cecum, as well as in the rectum.

Due to the multiplicity of foci of inflammation, intestinal function is disrupted, which becomes a factor in the development of anemia and hypovitaminosis.

Complications

Sometimes inflammation affects the intestinal wall so deeply that it can cause perforation, the appearance of adhesions or fistulas. Complications of Crohn's disease also include intestinal obstruction and internal bleeding. In rare cases, inflammation spreads from the digestive system to the skin (a rash, areas of peeling appear), joints (they can become inflamed and painful), eyes (vision is impaired, pain is noted), kidneys and other organs.

Symptoms

During exacerbations of the disease, when the intestines become inflamed, the child experiences:

Long-term elevated body temperature up to 37.5-38 degrees.
Attacks of abdominal pain - they are localized on the lower right or near the navel and are quite severe.
Diarrhea that lasts a long time or is repeated can sometimes be bloody. The child defecates up to 10 times a day.
Fatigue and fatigue.
Weight loss or insufficient weight gain.
Stunted growth.

When the stomach is affected, the disease manifests itself as vomiting, heaviness in the abdomen, and nausea. If the inflammatory process has affected the rectum, pain in the anus, constipation and bleeding may occur.

Treatment

When selecting treatment for a child with Crohn's disease, factors such as the activity of the inflammatory process, the child's condition, the severity of symptoms and other factors are taken into account. So the approach to the treatment of this disease will be individual. Medical nutrition plays an important role.

Medicines

If the disease is recently diagnosed, the child is prescribed anti-inflammatory drugs, immunosuppressive drugs and hormones (prednisolone). In addition, antibiotics, antidiarrheals, sorbents and enzymes may be prescribed.

If the course of the disease is severe, intravenous administration of electrolytes, amino acids, and plasma is prescribed. Sometimes, after a short course of drugs, long-term remission occurs, but often the drugs need to be taken for quite a long time.

Surgical intervention

You cannot do without it if the intestinal tissue is destroyed and the result is an abscess, narrowing of the intestinal lumen, or the formation of a fistula. Such complications can only be eliminated surgically. During surgery, the damaged part of the intestine is removed. Unfortunately, such treatment does not help to get rid of Crohn's disease completely, so surgery is resorted to only when absolutely necessary.