The fact that an inflammatory bowel disease diagnosis usually occurs in patients between the ages of 15-30 makes the issue of growth a big one for doctors, families, and patients. There are also many people who are diagnosed even younger which obviously exacerbates this concern.
Crohns disease and ulcerative colitis are extremely challenging to manage for several reasons. The first being that everyone’s’ body reacts differently to the disease. There are people who have had one flare up of ulcerative colitis or Crohns in their entire life and pretty much forget they have the disease except for routine checkups. And of course there are others whose disease impacts every aspect of their life because it is so severe. The second reason why IBD is difficult to manage is because it is impossible to predict how a person’s body is going to respond to medication or surgery. There is no clear way to go in terms of treatment so oftentimes there is a lot of trial and error with various medicine cocktails. In addition, when surgery is needed, it can come with complications in some patients, while others have relatively smooth operations. The last thing and the one I want to talk about in this post is that inflammatory bowel disease can have a huge affect on a patient’s growth; especially if they were diagnosed at a young age.
Between the harsh medications IBD patients are put on, surgeries and the stress that has on the body, and the fact that it is usually difficult for someone who has a severe form of Crohns disease or ulcerative colitis to eat a balanced diet, younger patients can have a hard time growing and thriving at a rate that would be considered normal for someone their age. If their IBD is present in the small intestine it could also cause absorption problems, short gut syndrome, etc. Not to mention, when IBD is active, even water bothered me so I did everything I could not to eat. The psychological ramifications of dealing with a chronic illness that affects your digestive system often leaves a patient feeling like food is the enemy.
I was lucky in that even though I was diagnosed with ulcerative colitis at the age of 13, I already had my period for two years. A doctor once told my mom and I that girls usually stop growing two years following menstruation. When I was younger, I was always taller than most girls my age and was bigger too. Not fat but hardly tiny. At the age of 10, my pediatrician told me that I would likely be 5’6 or 5’7 given how I was growing. For those of you who know me, you know I am about four inches shorter than that : )
Immediately following my diagnosis, I was put on 40mg of prednisone which was then increased to 80 very quickly. When I was receiving it intravenously, the prednisone side effects was magnified. For those of you who don’t know that much about this particular drug, it is a steroid that is beneficial with inflammation. But it can be dangerous for so many reasons which is why a patient needs to be weaned off very slowly thus increasing the time the drug is in his/her body.
I stopped growing when I was put on prednisone but then a few years later, my height increased by about half an inch for some reason. I wasn’t any healthier; I was just off of the prednisone. I am a little less than 5’3 which is a fairly average height for a woman. Like I said, I was extremely fortunate to have matured earlier than most.
The issue of growth and nutritional health in IBD patients, particularly pediatric patients, is a big concern. There are a lot of supplements a person can take but it is essential he/she is careful about popping vitamins haphazardly because you never know what could interfere with the medications you are taking. There is also an enormous psychological impact that being a smaller child has on kids. I would venture to guess (but don’t quote me on this) that it is probably more difficult for a young boy. It affects both genders in athletic activities because if you aren’t able to eat well (or enough), you don’t have the necessary strength to keep up with peers. That is frustrating in and of itself.
Inflammatory bowel disease impacts the lives of patients and caregivers more than the public realizes. Even something as seemingly simple as growth can have emotional and physical ramifications. It is so important to be an educated patient/caregiver, get blood checked regularly, and speak with your doctor if you feel you or your child isn’t thriving. There are nutritionists, dieticians, and specialized doctors who are available to patients and their families who are struggling with this.
However, any good gastroenterologist will keep all of these things in mind when treating you or your child but that doesn’t mean you shouldn’t be on top of this as well.