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PrintAdvances in Pediatrics: Relief for Crohn's disease
Some illnesses continue to baffle the medical community, and Crohn’s disease, a chronic disorder that causes inflammation of the gastrointestinal (GI) tract, is one of them. The trouble is it’s difficult to diagnose and treat, and doctors still aren’t sure what causes it. Moreover, the disease seems to be affecting more children than in the past.
“We have seen a dramatic increase in the number of young patients with the disease,” says Stuart Berezin, M.D., Chief of Pediatric Gastroenterology at Maria Fareri Children’s Hospital at Westchester Medical Center. “And no one knows why.” While Crohn’s disease most commonly begins in teenagers, “we are seeing more children in the 3 to 5 age range,” he adds. “We even see kids not yet 1 year old. It’s just unbelievable.”
Dr. Berezin explains that the increased number of cases is partly due to advances in diagnosing the disease. (In the past, it was harder to diagnose due to its similarities to inflammatory bowel diseases.) Endoscopy, which involves sending a scope into the GI tract, is much more sophisticated today, he says, allowing for better pictures of the digestive tissue and the ability to biopsy the site. The hospital’s gastroenterologists also use capsule endoscopy, in which the patient swallows a capsule that contains a camera, which has only recently been approved for pediatric use. “It takes pictures as it passes through the GI tract,” Dr. Berezin says. “We can see the entire small intestine better than ever before.” Finally, magnetic resonance imaging (MRI) has taken the place of X-rays and CT scans to provide better imaging without radiation exposure.
Thankfully, improved treatments, including new medications and intravenous infusions designed to combat the biochemicals that cause inflammation, are now available. “The majority of our kids do very well on these treatments,” he reports.
Left untreated, Crohn’s disease can cause bleeding in the GI tract, which could cause anemia. And children with it might suffer delayed development and stunted growth.
Several theories exist about what causes Crohn’s disease: one is that the body’s immune system reacts abnormally in people with the disease, mistaking bacteria, foods and other substances as foreign “invaders” and attacking them with immunity cells. These cells accumulate in the lining of the intestines, producing chronic inflammation, which leads to ulcerations and bowel injury.
