Dr Andrew Day talks about the symptoms, testing and treatment of Crohn’s disease and colitis in children.

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Inflammatory Bowel Disease (IBD)
For more information on inflammatory bowel disease, including how the digestive system works, types of IBD and useful videos, see Inflammatory Bowel Disease (IBD).

Hello, my name is Andrew Day, Paediatric Gastroenterologist based in Sydney, Australia. I work at the Children’s Hospital at the University of New South Wales. I’m also the head of my Department of Gastroenterology at Sydney Children’s Hospital and have many roles including looking after in-patients, seeing children in my out-patient clinic, performing endoscopy procedures, teaching and running my research team. I joined the Editorial Advisory Board of the Virtual Gastro Centre two years ago and one of my main interests is the area of Crohn’s and colitis in children. I also have a particular interest in coeliac disease and nutrition in childhood.

I lead a Crohn’s and Colitis clinic which is a multidisciplinary clinic catering for infants, children and adolescents with Crohn’s and colitis. We work to ensure that these children receive well-balanced care covering all elements such as growth, nutrition and control of their disease.

Inflammatory bowel disease encompassing Crohn’s and colitis is becoming increasingly common in children of all ages. However, they most commonly begin in teenage years. Children with Crohn’s and colitis often have weight loss or poor height gains before diagnosis. And this may lead to long-term problems such as slow start of puberty or poor height growth. It is important to ensure that IBD is recognised and diagnosed properly in children to help prevent these longer-term complications.

We’ve been working to find new ways to detect changes in the gut sooner. One of these new tests is called S100-A12. This protein is made in increased amounts by inflamed cells in the bowel. This protein can be easily measured in the stool and can give us a reliable indication of the amount of inflammation in the bowel.

By using this new mark of inflammation in children who have symptoms such as abdominal pain we should be able to work out sooner whether or not they have a serious problem needing more tests. It should also be helpful to show when children have responded to medicines and to detect flare-ups of disease over time.

One of the treatments that is particularly relevant in children with Crohn’s is called exclusive intra nutrition. This treatment heals the surface of the bowel, and also improves growth and nutrition. It does require patients to take special drinks for up to 8 weeks and for them to not have the usual diet during this time. It does however lead to less side-effects than some other therapies that can be used for Crohn’s disease.

Whilst working to improve the care and management provided to children and adolescents with IBD, my team and I are also working to understand the basic events occurring in these conditions. Hopefully in time we will be able to provide a cure to these patients.

Thank you very much for watching.

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