The classical features of Crohn’s disease include full-thickness acute and chronic inflammation, and “skip lesions” – which means that part of the bowel will be affected and other parts will appear normal. These are assessed by a colonoscopy.
Crohn’s can involve any part of the gastrointestinal tract, and may lead to various symptoms, including diarrhoea, pain and weight loss. Nutrition and growth may be adversely affected due to the disease.
Medically this considered to be is a life-long condition without a cure. It tends to have periods of exacerbation and remission, which meanst that there are typically episodes of no symptoms, interrupted by the reappearance of symptoms.
Various therapeutic options are available, including medical, surgical and nutritional options. The aims of management include controlling the inflammatory process, resolving symptoms and preventing complications. In children and adolescents, further critical aims are ensuring normal growth and development.
A nutritional approach to the management of Crohn’s Disease has been supported by recent research, with the benefit of controlling inflammation, reducing symptoms and optimising growth. A great advantage is the minimal side-effects and permitting avoidance of other therapies that may adversely impact on children with regards to growth, development and socialisation.
Nutritional Impact of Crohn’s Disease in Children
Almost all children with Crohn’s have a history of weight loss or lower-than expected weight gain. This is typically due to decreased intake, due to the anorexic effects the disease process, plus pain and feeling full after a small amount of food.
Other contributory factors include malabsorption or increased energy requirement. Children often exhibit poor growth and delayed onset of puberty. This can mean that a child might not reach their full height potential.
Inflammatory Bowel Disease (IBD) is associated with a number of nutrient deficiencies, with iron and vitamin D deficiency being the most common. Other deficiencies – such as vitamin B12, folate, vitamin K or calcium – are also frequent. The consequences of these impairments include specific deficiency syndromes and poor bone health, with growing pains, osteopaenia and osteoporosis. Because of the significance of these nutritional complications it is very important to focus on ensuring adequate nutrition to maximise growth potential and avoid long-term complications.