saudigastro.com/patients/pediatric-ibd
Category
Chronic
Red flags
5
This article is educational and does not replace your doctor's advice. Seek urgent care for any red-flag symptoms.
What is it?
Inflammatory bowel disease (IBD) is a long-term condition in which the immune system causes ongoing inflammation in the digestive tract. The two main types are Crohn's disease, which can affect any part of the gut from mouth to anus, and ulcerative colitis, which affects the large bowel (colon) and rectum. In children, IBD can be more extensive than in adults and can slow growth and delay puberty, so early diagnosis and a specialist paediatric team are important.
How common is it?
IBD is much less common in children than in adults, but the number of children diagnosed has been rising in many parts of the world. It can appear at any age, including in young children, although it is most often diagnosed in the teenage years.
Why does it happen?
The exact cause is not known. IBD is thought to result from a mix of genes, an overactive immune response, gut bacteria, and environmental factors. It is not caused by anything the parents did, by stress, or by a particular food. It is not infectious. Having a close relative with IBD raises the chance, but most children with IBD have no family history.
Symptoms
- Ongoing diarrhoea, sometimes with blood or mucus
- Belly pain or cramps
- Weight loss, poor weight gain, or slow growth
- Tiredness, pale skin (anaemia), and poor appetite
- Delayed puberty or a teenager who has stopped growing in height
- Fever that comes and goes, mouth ulcers, or painful joints
- Sores, tags or abscesses around the anus
Red flags — seek urgent medical care
Severe or constant belly pain, a swollen hard belly, or repeated vomiting
May mean a blockage or serious inflammation. Go to the emergency department now.
Frequent bloody diarrhoea with fever, fast heartbeat, dizziness or looking very unwell
Can be a severe flare or serious infection. Your child needs to be seen immediately.
Signs of dehydration: very dry mouth, no urine for many hours, sunken eyes, extreme sleepiness
Needs urgent care and often fluids given in hospital.
Severe pain, redness or swelling around the anus with fever
May be an abscess that needs prompt treatment.
Red, painful eye or severe headache while on treatment, or any fever while on immune-suppressing medicine
Contact your IBD team the same day, as infections can be serious in children on these medicines.
How is it diagnosed?
Diagnosis needs a specialist paediatric team. It usually involves blood and stool tests (including a stool test for gut inflammation), and then endoscopy of the upper gut and colonoscopy under anaesthetic or sedation to look at the lining and take small tissue samples (biopsies). Imaging of the small bowel, such as MRI or ultrasound, is often used in Crohn's disease. Growth, puberty stage, and nutrition are checked as part of the assessment.
What the latest science says
In children with Crohn's disease, a carefully supervised liquid nutrition programme can calm inflammation in some patients, and treating early and closely monitoring the disease is increasingly emphasised to protect growth. Treatment plans are individual and decided by your child's specialist.
Outlook — what to expect
IBD is lifelong with periods of flare and calm (remission). With modern treatment and regular follow-up, most children and teens reach good control, attend school, play sport and grow into healthy adults. Good control matters because uncontrolled inflammation can harm growth and bone health. Moving from paediatric to adult care is planned gradually.
Treatment
Habits & Lifestyle
Day-to-day habits help your child feel well and stay on track.
- Give medicines exactly as prescribed, even when your child feels well. Do not stop them without the team's advice.
- Keep all clinic, blood test and growth check appointments.
- Encourage regular physical activity, sleep, and time with friends. Normal life is the goal.
- Keep vaccinations up to date, and ask the team before any live vaccine if your child is on immune-suppressing medicine.
- Teenagers should not smoke or vape; talk openly and offer support.
- Look after emotional health. Anxiety, low mood and school worries are common, and help is available.
Diet
Good nutrition is part of treatment because IBD can make it hard to grow.
- Aim for a balanced, varied diet with enough calories and protein for growth. Avoid cutting out food groups without advice.
- A dietitian from the IBD team can advise on high-energy foods, supplements and, sometimes, a special nutrition programme.
- During a flare, small frequent meals and extra fluids may be easier. Follow your team's advice about fibre.
- Ask about vitamin D, calcium, iron, and other supplements. Do not start supplements or restrictive "IBD diets" from the internet without discussing them first.
Medications
Treatment aims to settle inflammation, support normal growth, and prevent flares. The specialist chooses the plan for each child.
- Different medicine groups may be used, including anti-inflammatory medicines, steroids for short periods to calm a flare, immune-modulating medicines, and biologic medicines.
- Steroids are used for short periods because long use can affect growth and bones.
- Your child will need regular blood tests and check-ups to watch for side effects and to check that the treatment is working.
- Report any fever, infection, or new symptoms promptly when on immune-suppressing medicine.
- The doctor decides medicines, doses and how long to use them. Do not change or stop them yourself.
Procedures & Surgery
Procedures help diagnose and monitor the disease; surgery is used only for some children.
- Endoscopy and colonoscopy are used at diagnosis and sometimes later to check healing, usually under anaesthetic or sedation.
- MRI or ultrasound can check the small bowel without radiation.
- Surgery may be considered for complications (such as narrowing, abscess or fistula) or when medicines no longer control the disease. The surgical team will explain the options.
Living with the condition
- Tell the school about your child's condition so they can allow toilet access and support absences.
- Help your child understand the condition in age-appropriate ways and encourage them to take part in their own care as they grow.
- Support groups and counselling can help the whole family.
In the Saudi context
If your child is old enough to fast in Ramadan, speak with the IBD team well in advance. Fasting may not be advisable during a flare or if medicine, nutrition or growth are a concern. The team can advise on safe timing of medicines. Islamic rulings allow exemption from fasting for illness; your doctor and religious scholar can guide you.
Questions to ask your doctor
Save this list or print it before your appointment — doctors appreciate prepared patients.
- Which type of IBD does my child have and how active is it?
- How will you track my child's growth and puberty?
- What are the treatment options, and what side effects should I watch for?
- Does my child need a special nutrition plan or supplements?
- What should we do during a flare, and who do we call?
- How will we plan the move to adult care?
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Status: Approved for publication by SGA; individual clinician review is ongoing · Published 24/04/2026
For general education only; it does not replace your doctor’s advice. Individual clinician review of this guide is ongoing. SGA clinician? Review this guide