Inflammatory Bowel Disease in Children, Teens

Crohn's Disease, Ulcerative Colitis, and Indeterminate Colitis

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Inflammatory bowel diseases (IBD) -- including Crohn's disease, ulcerative colitis, and indeterminate colitis -- are chronic, lifelong autoimmune conditions. While there is no cure, children and teens with these conditions benefit from the many effective treatments are available. Duke's pediatric gastroenterologists, nurses, dietitians, social workers, and mental health specialists address the physical and emotional aspects of your child’s illness. We work with you and your child to reduce or eliminate symptoms and ensure proper nutrition so your child can achieve healthy growth and enjoy everyday activities.

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Diagnosing and Treating Inflammatory Bowel Disease in Children

Inflammatory bowel disease causes inflammation in the small intestine, colon (large intestine), stomach, and other areas of the digestive tract. Symptoms can vary and may include frequent stomach pain, diarrhea, bloody stool, and weight loss.

Accurate Diagnosis Is Key to Treatment
It is important to get an accurate diagnosis for your child, as treatments can differ for Crohn’s disease and ulcerative/indeterminate colitis. Making a diagnosis is like putting together a puzzle. Different pieces -- symptoms, lab work, imaging tests -- help us build a complete picture of your child’s IBD.

Evaluation and Testing
If inflammatory bowel disease is suspected, your child will be tested for:

  • Anemia
  • Elevated inflammatory markers
  • Low protein levels
  • Vitamin/nutrient deficiencies (vitamin B12, folate, vitamin D, zinc, iron)

Additional tests and exams include:

  • Stool Samples: Tested to rule out other conditions such as gastroenteritis.
  • Upper Endoscopy or Colonoscopy: Checks for chronic inflammation in the digestive tract.
  • CT Enterography or MR Enterography: Images of the abdomen and pelvis are taken using special methods to increase contrast, allowing us to look for inflammation in the bowel.

Treatment and Ongoing Care
After an initial diagnosis, most children see our pediatric gastroenterologists frequently until their condition is in remission. After your child is in remission, we will see them every two to six months, depending on their condition. Your child’s doctor will perform a physical examination and will assess growth and development. Lab tests ensure the disease is under control and to monitor side effects. Even if your child is feeling well, they should still be seen by their doctor at least once or twice a year.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Crohn's Disease Treatments


Prednisolone, prednisone, and budesonide may be prescribed to reduce inflammation. They are used for short periods of time to reduce the risk of long-term side effects.

Immune Suppressants

Azathioprine, 6-mercaptopurine, and methotrexate are used in uncomplicated forms of Crohn's disease to maintain remission of mild-to-moderate disease. They suppress an overactive immune system to heal inflammation.

Biologic Treatments

Infliximab, adalimumab, certolizumab, vedolizumab, and ustekinumab are anti-inflammatory agents that treat inflammation in children with moderate-to-severe Crohn’s disease or forms of Crohn’s disease complicated by fistulas and/or strictures. They are given by injection or by intravenous infusion.

Enteral Nutrition Therapy

Children with certain forms of Crohn's disease may be treated with exclusive or partial enteral nutrition therapy, which replaces regular food with liquid nutritional formulas. Both forms are given for six to 12 weeks. Your child can drink the formula by mouth or it can be given through a nasogastric tube placed through the nose and into the stomach. Enteral nutrition therapy can help avoid the need for steroids or other medicines and their side effects. Nutrition therapy can restore growth, but some children may experience diarrhea in the early stages of treatment.

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Ulcerative Colitis Treatments

Anti-Inflammatory Mesalamine

Treats mild-to-moderate forms of ulcerative colitis. It can be taken by mouth or by rectum as a suppository or enema.

Immune Suppressants

Azathioprine, 6-mercaptopurine, methotrexate, and other immune-system-suppressing medications treat moderate-to-severe forms of ulcerative colitis.

Biologic Agents

Infliximab, adalimumab, golimumab, vedolizumab, and other biologic agents treat moderate-to-severe cases of ulcerative colitis.

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 10 pediatric specialties.

Why Choose Duke

Family and Support Services
Living with and managing an inflammatory bowel disease can be exhausting and overwhelming. When you come to Duke Children’s for your child’s care, our team is here to help. Our doctors and nurses will connect your child and you to additional services to answer your questions and provide the extra support you need.

Mentorship for Teens with IBD
Duke's Adolescents Transitioning to Leadership and Success (ATLAS) Program helps teenagers prepare to be young adults living with inflammatory bowel disease. Teens are paired with college students from Duke University. These older students are living successful lives with IBD, and they serve as mentors to the teens. Mentors share advice about going to college, managing medicines, how to get help when you need it, and even issues around dating. Adolescents participating in ATLAS who are departing for college are given the opportunity to spend a weekend on campus to practice self-management skills with program mentors. 

Parent Working Groups
These sessions give newly diagnosed families an opportunity to speak and interact with families who have been living with inflammatory bowel conditions for a long time. We can pair your family with others who will share their experiences with you, thanks to our partnerships with the Crohn's and Colitis Foundation and Improve Care Now. As a member of Improve Care Now, we collaborate with more than 100 pediatric gastroenterology centers around the world to improve the care of children with IBD. 

Help Navigating the Medical System
Our social workers can help you navigate the medical system and coordinate the variety of health services your child needs. We help you work with insurance providers, connect with resources, and manage details related to your child’s care.