Pediatric IBD Treatment at Columbia

There is no cure for IBD but with long-term care and management children with IBD, Crohn’s disease, and ulcerative colitis can live active, full lives. The goal of treatment is to relieve symptoms, prevent flare-ups, and heal the intestine—so your child can lead a normal life.

Treatments may include:

• Medications by mouth
• Medications that are injected
• Medications given intravenously
• Nutritional therapy
• Surgery

Every child in our program has a different treatment plan, which is developed with family members based on your child’s age, symptoms, severity of the disease, and family. Our nursing and nutrition teams will work closely with you to ensure you are equipped to carry out the plan safely and confidently.

Adequate nutrition is critical for children with IBD. In addition to treatments, the plan will include disease monitoring, nutritional counseling, and assessment of your child’s growth.

About the IBD Center

Medication

Medications will most likely be part of your child’s long-term treatment plan. With advances in knowledge about IBD over the past decades, there are now many different types of medical therapy. Medications are sometimes used in combination with each other, and they may be given to your child orally, by injection, or intravenously. Intravenous (IV) medications are given in our state-of-the-art infusion center.

• Antibiotics may be prescribed when infection is a concern, or in combination with other medications for Crohn’s disease. 
• Steroids help reduce inflammation during a flare. They can also relieve symptoms such as rectal bleeding, fever, and joint pain.  Steroids may be given orally, topically, or intravenously. 
• Aminosalicylates decrease inflammation in the wall of the intestine. They are mainly used for ulcerative colitis but sometimes prescribed for Crohn’s disease as well. 
• Immunomodulators decrease immune system activity. They are generally used in patients with Crohn’s disease or ulcerative colitis who are not responding to other treatments.
• Biologics target specific proteins that are known to cause inflammation. They are generally given intravenously to children in whom traditional medical therapy is not working or is causing side effects.  

Nutritional Therapy

Children need proper nutrition in order to grow and develop strong bones, and intestinal inflammation caused by IBD can prevent the absorption of key nutrients. Nutritional therapy is an important component of IBD treatment for children and may be used in combination with one or more medications. Nutritional therapy for your child may include: 

• Specialized diets: Research has shown that certain diets may reduce IBD inflammation and promote healing. The Pediatric IBD Center has extensive expertise with dietary therapies and the challenges they pose for children and their families.
• Enteral nutrition therapy: A form of treatment for IBD in which all nutrition and calories are taken in liquid form, either orally or through a tube, for six to 12 weeks, to treat inflammation and ensure proper nutrition. Learn more about enteral nutrition therapy. 
• Nutrition support: Studies have shown that certain diets can reduce inflammation and promote healing of the intestine. Your family will work with a nutritionist to monitor your child’s diet, make sure your child is getting proper nutrition for his or her growth, and navigate the challenges of restricting diets in children and adolescents.

Surgery

For some children, surgery is an option, especially for those who do not respond to medications or when medications stop working. We work closely with families who are considering surgery for IBD. Columbia’s pediatric surgical team is world-renowned for its expertise in surgical treatment of children of all ages and has some of the best outcomes in the country.

Surgery for Crohn’s disease is called resection. A portion of the intestine that is damaged is removed and the remaining parts are reconnected.  Resection can help your child respond to medications or provide important relief from symptoms. Resection is generally a temporary solution, because symptoms tend to recur.

Surgery for ulcerative colitis is called colectomy and can eliminate the condition. Some or all of the large intestine is removed. In many cases, the small intestine is modified to create a new rectum, which is done in a second surgery. 

Monitoring

People with Crohn’s disease and ulcerative colitis require lifetime monitoring by a gastroenterologist with expertise in IBD. In children and adolescents, this is particularly important because they are still growing. Monitoring will be a key component of your child’s treatment plan, so that we can help make sure treatment is leading to normal growth and development. 

About Inflammatory Bowel Disease in Children