Pediatric inflammatory bowel disease (IBD), the most common forms of which are Crohn’s disease and ulcerative colitis, is a group of inflammatory disorders affecting 100 to 200 of every 100,000 American children.
Today, the patient experience for affected children has been substantially enhanced thanks to the emerging use of intestinal ultrasound (IUS). IUS is helping clinicians visualize a child’s intestinal tract during an office visit, fast-tracking diagnosis and treatment, and reducing the number of invasive endoscopies and colonoscopies a patient may require over the course of treatment.
Nicklaus Children’s Hospital is at the forefront of adoption of IUS to support the diagnosis and management of IBD. It is the only hospital in Florida and one of only four children’s hospitals nationwide to offer this transformational technology for pediatric IBD patients.
“Our IUS ultrasound program has transformed our care for patients with IBD,” said Dr. Lina Maria Felipez, Associate Director of the Inflammatory Bowel Disease Center, Director of IBD research and Director of the Intestinal Ultrasound Program at Nicklaus Children’s. “This imaging procedure takes place in the office with no prep and – most importantly for our patients – no downtime.
Appointments with board-certified gastroenterologists and IUS consultations are offered right here in Miami Beach at the Nicklaus Children’s at Alton Road location. Pediatric and prenatal cardiology appointments are also available in Miami Beach. To learn more, please visit nicklauschildrens.org/AltonRoad.
Faster Access to Treatment
Benefits of IUS extend beyond the initial avoidance of discomfort of young patients.
“The time to diagnosis and treatment is greatly condensed with IUS,” said Dr. Felipez. Traditional diagnosis of Crohn’s and ulcerative colitis is a painstaking process requiring blood work and stool tests, endoscopy and colonoscopy and MRI. Now, likely IBD candidates are quickly identified in the office and referred for the initial colonoscopy required to confirm the diagnosis. This, in turn, leads to faster treatment and a reduction in discomfort and symptoms.
Enhancing Care Management Over a Lifetime
IUS also makes the course of treatment over a lifetime much easier for patients. Colonoscopy and endoscopy were once required standards of care for evaluating disease progression and the effectiveness of treatment. Even in remission, children underwent these exams as frequently as every 6-12 months.
Bypassing these tests in favor of IUS decreases sedation and preparation, reduces radiation exposure and further improves the care maintenance experience.
“IBD is a long journey, and we see children who are diagnosed at very young ages,” said Dr. Luis Caicedo Oquendo, Director of the Pediatric Gastroenterology, Hepatology and Nutrition Fellowship Program and Medical Director of the Fecal Care Program at Nicklaus Children’s. “Reducing a child’s exposure to radiation over the course of treatment is a significant benefit to using this technique.”
Causes and Symptoms of IBD
IBD is a lifelong condition that is associated with an overactive immune system. The immune system mistakenly attacks healthy bowel tissue, leading to inflammation, ulcers and other symptoms.
IBD typically affects young people ages 15 to 35, though children as young as 5 years old may develop IBD. Affected children tend to have a family member with IBD.
Children with IBD typically experience diarrhea and abdominal pain. Other gut symptoms include cramping, loss of appetite, weight loss, growth problems, fever, fatigue and delayed puberty.
Types of IBD
Inflammatory bowel disease includes several related illnesses that cause chronic inflammation of the gut, including swelling and damage of the bowel lining.
Ulcerative colitis and Crohn’s disease are two most common conditions classified as inflammatory bowel diseases. These two conditions have differences and similarities.
In ulcerative colitis only the lining of the large gut (colon) becomes inflamed and ulcerates, while Crohn’s affects all the layers of the bowel from mouth to anus. Both disorders may feature normal areas of bowel in between the inflamed parts.
Treatment Options for Children with IBD
While there is no cure for IBD, treatments including anti-inflammatory medications and advanced medical therapies such as biologics, can provide significant relief. Surgery to remove damaged portions of the digestive tract also may be necessary.
Getting Help for a Child in Need
If you or someone you know would like to schedule a child for evaluation of a bowel disorder, please speak to the child’s pediatrician or visit nicklauschildrens.org/Gastroenterology. To learn more about the intestinal ultrasound program, visit nicklauschildrens.org/IUS.
To make an appointment online with a board-certified gastroenterologist at any Nicklaus Children's location, click here.