For children and adolescents suffering from Crohn’s disease or ulcerative colitis, discerning the best course of treatment can sometimes be tricky.
Special diets, a variety of medication regimens and stress reduction may help alleviate symptoms for some or even send the diseases into remission. But, with no known cure for Crohn’s disease and a proven link between ulcerative colitis and colon cancer, surgical treatment is necessary for many patients.
Unfortunately, that includes children and adolescents stricken with one of these diseases. Saleem Islam, M.D., a UF associate professor of surgery and pediatrics and director of pediatric minimally invasive surgery at UF Health, is the institution’s leading pediatric surgeon treating patients with one of the two inflammatory bowel diseases.
At UF Health’s Inflammatory Bowel Disease clinic, pediatric surgeons, pediatric gastroenterologists, pediatric psychologists, pediatric radiologists, nutritionists, social workers, child life specialists, nurses and clinical pharmacists all work together to fully evaluate and treat each child or adolescent who comes through the doors. This multidisciplinary team works to help their patients be as healthy as possible, while striving to minimize procedures that will further interrupt childhood or adolescence.
For ulcerative colitis patients, surgery is especially taxing. It involves removing the colon and attaching the small intestine to the rectum, Islam explained.
“That’s going to lead to some higher number of bowel movements and loose bowel movements, and so if we can let them live with their colon through their adolescence, that probably is better,” he said.
Surgery becomes necessary for patients with Crohn’s disease when complications arise, such as a narrowed intestine that prevents the passage of digesting food or a hole that develops in the intestine, Islam said.
These problems require a surgeon to remove a diseased portion of the intestine, or to temporarily or permanently redirect waste into a bag called a stoma, which attaches to the outside of the abdomen.
“I’d say about 50 percent of children with Crohn’s will end up getting at least one surgical procedure during their childhood,” Islam noted.
In addition to treating children with inflammatory bowel disease, UF Health’s IBD team also researches outcomes among patients who undergo surgery, as well as the incidence of Crohn’s disease in children who have already undergone a colectomy to treat ulcerative colitis.