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"What is the normal treatment for children with Crohn's disease?"
My 12 year old nephew was just seen by a doctor who says he probably has Crohn's disease, so I'm trying to understand what this means for his future. What are the typical treatments for someone his age? What kind of diet will he have to eat? What are the chances he'll recover from this by the time he's an adult?
I am sorry to hear that your nephew likely has Crohn's disease. Crohn's disease is a difficult autoimmune condition in which areas of the intestine become inflamed. This can lead to bleeding, weight loss, pain, nutritional problems, and occasionally more serious complications. Unfortunately, Crohn's disease is not curable, and it is a lifelong illness; however, with good medical care, many cases can be well controlled. The cornerstone of Crohn's disease management is first to induce remission of the worst symptoms. This is usually accomplished with steroids such as prednisone. Severe symptoms flares may require hospitalization to induce remission of symptoms. Not eating or eating only bland soft foods is often a part of the treatment to induce remission. Following remission, children are started on medications to keep the symptoms in remission, or maintenance therapy. Several medications are used for maintenance therapy, most of which are immunosuppressive drugs. Commonly, azathioprine or 6-mercaptopurine are tried first. In refractory cases that do not respond to these drugs, second line drugs including infliximab or methotrexate. Some cases of Crohn's disease do not respond to these medications, and in these cases surgery to remove the affected part of the intestine may be required. Most cases of Crohn's disease, except for the simplest cases, should be managed by specialist pediatric gastroenterologists.
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