Inflammatory bowel disease

1. Big picture

Inflammatory bowel disease (IBD) is a chronic relapsing inflammatory disease of the gastrointestinal tract. In children, it is especially important because it affects not only the bowel, but also growth, puberty, nutrition, school life, bone health, and psychosocial development.

The two main types are:

1. Crohn disease
2. Ulcerative colitis
3. IBD-unclassified when features overlap

For the exam, think:

Child/adolescent with chronic abdominal pain, diarrhea, blood in stool, weight loss, growth failure, anemia, or delayed puberty
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Think IBD
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Exclude infection
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Check inflammation and nutrition labs
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Fecal calprotectin
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Endoscopy with biopsies + imaging
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Classify: Crohn vs ulcerative colitis
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Induce remission → maintain remission → protect growth/puberty

Most important pediatric clue: A child with “functional abdominal pain” should still grow normally. Growth failure, weight loss, anemia, nocturnal diarrhea, blood in stool, or delayed puberty are red flags for organic disease such as IBD.

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