Diagnosis and Treatment
How We Diagnose IBD
During your first visit to our pediatric IBD center, we will give your child a physical examination and ask you for a full medical history. We will also want to schedule some tests, which may include:
- Blood tests - checks for anemia and inflammation.
- Stool sample - checks for infectious agents and inflammation.
- Imaging studies - may include magnetic resonance enterography (MRE), CT scan, barium X-ray, DEXA scan, and/or bone age assessment.
- Endoscopic procedures - such as upper endoscopy (examines the esophagus, stomach, and the duodenum, or upper part of the small intestine), colonoscopy (examines the colon and end of the small intestine), and/or video capsule endoscopy.
- Biopsy evaluation - tests tissue samples that are taken during a colonoscopy or upper endoscopy.
Our Approach to Care
If your child has been diagnosed with IBD, our expert pediatric care teams will individualize and tailor your care based on your child’s unique needs. Our goal is to manage and monitor your child’s condition from diagnosis until adulthood so that any disease progression can be managed quickly and effectively.
At NewYork-Presbyterian, every child in our pediatric IBD center has an individualized treatment plan based on the child’s age, symptoms, severity of the disease, and guided by their parents’ input. Our nursing and nutrition teams will work closely with you to ensure you are equipped to carry out the plan safely and confidently. In addition to treatments, the plan will include disease monitoring, nutritional counseling, and assessment of your child’s growth.
While currently there is no cure for IBD, with long-term care and management children with Crohn’s disease and ulcerative colitis should usually live active, full lives.
Holistic and Comprehensive Care
We recognize that every child with a digestive disorder such as IBD has a unique set of symptoms, circumstances, and needs. We take a holistic approach to care that considers the entire patient, including his or her physical, emotional, and social factors. We strive to partner with patients and their parents in shared decision-making, empowering them with knowledge, support, and the most effective treatment options to achieve the best possible outcome for every child.
Multidisciplinary Team Approach to Care
At NewYork-Presbyterian’s pediatric IBD centers, our multidisciplinary teams include pediatric gastroenterologists, pediatric nurse practitioners, social workers, and nutritionists. The team may also include other specialists with IBD expertise, such as pediatric surgeons, colorectal surgeons, dermatologists, ophthalmologists, rheumatologists, endocrinologists, immunologists, and geneticists.
Continuity of Care throughout the Lifespan of the Child
At NewYork-Presbyterian, a vital aspect of our digestive disease program is continuity of care. Children who have a lifelong need for specialized care, such as those diagnosed with IBD, are embraced by our care teams. We understand the continuous needs of patients regardless of age and are vested in making certain that the transition from childhood to adulthood is simplified by not needing to change care teams. Our integrated care team seamlessly transitions patients from childhood through the teen years and early adulthood.
Transitioning to Adult Care
Adolescents with IBD face unique challenges that can hamper the successful transition from pediatric to adult health care. Not only are they coping with age-related issues concerning body image and self-consciousness, but they also experience symptoms of their IBD that can arise without warning and cause anxiety, stress, embarrassment, feelings of helplessness, and depression. The NewYork-Presbyterian Pediatric IBD Transition Program takes a multidisciplinary approach to enlist the expertise of pediatric gastroenterologists, adult gastroenterologists, nutritionists, psychologists, and social workers to optimize care during this transition period. We collaborate to provide patients with knowledge, self-reliance, and self-management strategies that will prepare them for a successful transition to the adult gastroenterology environment and empower them with the know-how to care for themselves throughout adolescence and beyond.
Parents As Team Members
As a parent, only you can provide important information about your child, especially how they were before becoming ill, and how they are feeling now. You can also help other team members shape your child's personalized treatment program based on your child's physical, emotional, and practical needs. Your input is critical for making final decisions regarding your child's care. Our multidisciplinary team is here to work alongside you and your family to achieve the greatest possible outcomes for your child.
How We Treat IBD
Treatments for IBD are individualized to each child’s age, symptoms, the severity of the disease, and family and social factors. The goal of treatment is to relieve symptoms, prevent the occurrence of symptoms, and heal the intestine so your child can lead a normal life.
Medications will most likely be part of your child’s long-term treatment plan. With advances in knowledge about IBD over the past decades, there are now many different types of medical therapy. Medications are sometimes used in combination with each other, and they may be given to your child orally, by injection, or intravenously. Intravenous (IV) medications are given in our infusion center.
- Antibiotics may be prescribed when an infection is a concern, or in combination with other medications for Crohn’s disease.
- Steroids help reduce inflammation during periods of symptoms. They can also relieve symptoms such as rectal bleeding, fever, and joint pain. Steroids may be given orally, on the skin, or intravenously.
- Aminosalicylates decrease inflammation in the wall of the intestine. They are mainly used for ulcerative colitis.
- Immunomodulators decrease immune system activity. They are generally used in patients with Crohn’s disease or ulcerative colitis for specific goals.
- Biologicals target specific proteins that are known to cause inflammation. They are given intravenously or by injection. They are credited with changing the face of IBD treatment and outcomes. We offer infusions on-site at our facilities, as well as opportunities to have infusions at home.
Children need proper nutrition in order to grow and develop strong bones, and intestinal inflammation caused by IBD can prevent the absorption of key nutrients. Nutrition as therapy can be an important component of IBD treatment for children and may be used in combination with one or more medications. Nutritional therapy for your child may include:
- Specialized diets: Certain diets may reduce IBD inflammation and promote healing. Our pediatric IBD centers have extensive expertise with dietary therapies and working through the challenges they pose for children and their families.
- Enteral nutrition therapy: A form of treatment for IBD in which all nutrition and calories are taken in liquid form, either orally or through a tube, for six to 12 weeks, to treat inflammation and ensure proper nutrition.
- Nutrition support: Your family will work with a nutritionist to monitor your child’s diet, make sure your child is getting the proper nutrition for their growth, and navigate the challenges of restricting diets in children and adolescents.
For some children, surgery is an option, especially for those who do not respond to medications or when medications stop working. We work closely with families who are considering surgery for IBD. Our pediatric and colorectal surgical teams are world-renowned for their expertise in the surgical treatment of children of all ages and have some of the best outcomes in the country.
- Resection: Sometimes a portion of the small intestine is beyond medical management and requires removal. Resection may be required urgently or sometimes can be planned electively. For children with Crohn’s disease surgery is .not considered a cure and your child will require ongoing monitoring and appropriate therapy.
- Colectomy: For patients with ulcerative colitis the colon can be entirely removed, thus eliminating the diseased organ. Patients who undergo colectomy have a variety of options including those that restore anal elimination. Our expert surgeons are world leaders in this kind of surgery.
People with Crohn’s disease and ulcerative colitis require lifetime monitoring by a gastroenterologist with expertise in IBD. In children and adolescents, this is particularly important because they are still growing. Monitoring will be a key component of your child’s treatment plan so that we can help make sure treatment is leading to normal growth and development.
Support for Patients and Families
At NewYork-Presbyterian, pediatric care includes additional complementary services to help patients and families fully manage their care. Patients with IBD may receive nutritional consultation from a registered dietitian, individual or family counseling with a social worker, or help from our patient navigator to file accommodation plans at school.
The pediatric IBD centers at NewYork-Presbyterian offers a variety of support groups. These groups are designed to help patients and families express their concerns in a supportive environment and to better understand their condition. Parents or caregivers are also welcome to attend these groups.