Crohn's Disease in Children and Teens

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Medical Author:

Andrew B. Grossman, MD

Coauthor:

Petar Mamula, MD

Medical Editor:

Bhupinder Anand, MD

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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• Crohn's Disease in Children and Teens Overview
• Crohn's Disease in Children and Teens Causes
• Crohn's Disease in Children and Teens Symptoms
• When to Seek Medical Care
• Exams and Tests
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Crohn's Disease in Children and Teens Overview

Crohn's disease is a serious, chronic disease affecting the digestive system. Chronic means that the disease is long-term and persistent, usually lifelong. Crohn's disease causes inflammation, most often in the small intestine (which has three parts: duodenum, jejunum, and ileum). The walls and lining of the affected areas become red and inflamed, leading to ulcers and bleeding. Crohn's disease sometimes is named by referring to inflammation in the part of the intestine affected, such as jejunoileitis, ileitis, ileocolitis, or colitis (when it involves the large intestine, also called the colon).

Crohn's disease can appear at any age, but it is most often diagnosed in adults in their 20s and 30s. However, approximately 30% of people with Crohn's disease develop symptoms before 20 years of age. In the United States, about 100,000 teens and preteens have Crohn's disease.

Along with ulcerative colitis, a similar illness, Crohn's disease is also called inflammatory bowel disease, or IBD. Ulcerative colitis attacks only the large intestine in a continuous manner and does not affect the entire thickness of the bowel wall. Crohn's disease, on the other hand, can occur anywhere in the digestive tract, from mouth to the anus, attacks different sites in the intestine with areas of normal intestine in between ("skip lesions"), and affects the full thickness of the intestinal wall. Both conditions wax and wane: there are times when symptoms reappear or get worse (exacerbations or "flares") and other periods when symptoms get better or go away altogether ("remission").

While Crohn's disease causes many problems for people of all ages, it can present special challenges for children and teens. In addition to bothersome and often painful symptoms, the disease can stunt growth, delay puberty, and weaken the bones. Crohn's disease symptoms may sometimes prevent a child from participating in enjoyable activities. The emotional and psychological issues of living with chronic disease can be especially difficult for young people.

Crohn's Disease in Children and Teens Causes

Diet and stress do not cause Crohn's disease. They can worsen the symptoms, but they are not the cause of the disease.

We do not know exactly what causes Crohn's disease. Apparently an unknown triggering event alters the immune response in a genetically susceptible person. This abnormal immune response leads to ongoing inflammation of the intestines. Various immune abnormalities are common in individuals with Crohn's disease.

We do not know what makes a person "genetically susceptible" to Crohn's disease. In about 15%-20% of people, the disease runs in the family. This is especially true of people who develop the disease at a younger age. Several genes have been linked to the disease, but there is no clear pattern to how these genes interact to cause the disease. Mutations in one gene, called CARD15, are present in about 40% of people with Crohn's disease. However, this gene is also frequently present in healthy people who never develop this disease.

We also do not know what the triggering event might be. The bacteria that naturally live in the intestines (or some other bacteria or virus) may play a role in triggering the onset of the disease.