For most children with inflammatory bowel disease (IBD), treatment is a balance of medicines and nutritional support (see below). If these are not enough, or if your child has a serious complication, your child may need surgery.
The IBD Program at Seattle Children’s brings a team of specialists together in one place to give your child and family the most complete care. The program combines care from experts in digestive health, immune health, nutrition, surgery and psychology. You and your child are active partners in making treatment choices.
Goals of IBD Treatment
At the IBD Program, our goals for treating your child are to:
- Restore balance and health to your child’s body
- Relieve any pain or other symptoms caused by IBD
- Decrease inflammation and heal ulcers in your child’s intestines
- Make sure your child is getting good nutrition
- Restore your child’s growth and development
- Ensure your child builds the best bone density
- Help your child and family with the mental, emotional and social effects of IBD
Medicines for Inflammatory Bowel Disease
We start treatment for IBD with medicines and nutritional support. Medicines are mainly aimed at calming the immune system, which is too reactive, and reducing inflammation.
We try to avoid using corticosteroids (medicines that suppress the immune system) because they can cause long-lasting side effects if used again and again.
Several other medicines can help. They include a newer medicine called natalizumab. It limits the movement of overactive immune cells. It’s used in adults with Crohn’s disease and is available for children through the IBD Program.
Nutrition and Inflammatory Bowel Disease
The intestine’s job is to break down food so nutrients can be absorbed into the bloodstream. Inflammation from IBD can make it hard for your child to get enough nutrients to grow and develop. Nutritional support can help correct any shortfalls. In times when inflammation is under control, nutritional support is still important to maintain a healthy and balanced diet.
Nutritional support can mean changing what or how your child eats or using nutritional therapies (formulas or special diets).
The IBD Program team designs a complete nutrition plan for your child so they get enough calories and eat a range of foods, including fruits and vegetables.
There’s mounting evidence that certain nutritional therapies can reduce inflammation in Crohn’s disease. At the IBD Program, we embrace nutritional therapies and help families decide whether this type of treatment is right for their child and how to use it.
The program team can give you details and resources about the options. We work with you to decide the best ways to track your child’s progress and tell whether the therapy is working for them.
Surgery for Inflammatory Bowel Disease
Your child might need surgery if:
- They have serious inflammation that doesn’t get better with medicines and nutritional support.
- Their intestine gets very narrow or scarred because of IBD. This can block the intestine.
- Crohn’s disease affects the area around their anus. This can cause pain, infections and pockets of pus (abscesses).
Surgery is very different for Crohn’s disease and for ulcerative colitis.
For Crohn’s disease, surgeons repair or remove the affected part of the intestine and preserve as much of the healthy intestine as possible. Surgeons use many techniques to do this.
For ulcerative colitis, surgeons remove the entire large intestine (colon) and the lining of the rectum (or, rarely, the whole rectum). In most cases, they create a pouch inside the body from the end of the small intestine (ileum) to the anus. (This bypasses the large intestine.) Then they connect the small intestine to an outside opening made in the skin of the belly so waste can pass to a bag. This bag (an ileostomy bag) is attached on the outside. Later, when the inside pouch can take over, surgeons close the ileostomy. Rarely, a child’s digestive tract is not healthy enough to make a pouch inside that works; in this case, the child keeps the ileostomy.
Our surgeons are highly experienced at operations for both Crohn’s disease and ulcerative colitis. They are skilled in both laparoscopic surgery, or minimally invasive techniques, and in open methods (using a larger cut). Your child's surgeon will help you decide which technique is best for your child.
New Treatments for IBD
Seattle Children’s offers new and advanced treatments for children with IBD that are not offered everywhere. These include fecal microbiota transplant therapy (also known as stool transplant or feces transplant) for Crohn’s disease and ulcerative colitis, and stem cell transplant for some children with severe Crohn’s disease caused by immune deficiencies.
Read details about using medicine, nutrition, surgery and new treatments for Crohn’s disease or ulcerative colitis.