In­flam­ma­tory bowel dis­ease in young kids on rise in Canada: Study

The Observer (Sarnia) - - LIFE - SH­ERYL UBELACKER

TORONTO — Canada has one of the high­est rates of pe­di­atric in­flam­ma­tory bowel dis­ease in the world, and the num­ber of young chil­dren be­ing di­ag­nosed with the life­long dis­ease has risen dra­mat­i­cally, a study has found.

Re­searchers found cases of in­flam­ma­tory bowel dis­ease, or IBD, in chil­dren un­der age five went up by 7.2 per cent each year be­tween 1999 and 2010. IBD pri­mar­ily in­cludes Crohn’s dis­ease and ul­cer­a­tive col­i­tis — con­di­tions that af­fect the di­ges­tive tract and cause chronic di­ar­rhea, blood in the stool, ab­dom­i­nal pain and weight loss.

Crohn’s is known as the “cheekto-cheek dis­ease” be­cause it can cause de­struc­tive in­flam­ma­tion through­out the gas­troin­testi­nal tract from the mouth to the anus, but is of­ten con­fined to the lower part of the small in­tes­tine and the colon. Ul­cer­a­tive col­i­tis af­fects only the large in­tes­tine, or colon.

“The num­ber of chil­dren un­der five be­ing di­ag­nosed with IBD is alarm­ing be­cause it was al­most un­heard of 20 years ago and it is now much more com­mon,” said lead author Dr. Eric Benchi­mol, a pe­di­atric gas­troen­terol­o­gist at the Chil­dren’s Hospi­tal of East­ern On­tario in Ottawa.

The re­searchers, mem­bers of the Canadian Gas­tro-In­testi­nal Epi­demi­ol­ogy Con­sor­tium, an­a­lyzed health records in five Canadian prov­inces to iden­tify chil­dren un­der age 16 who were di­ag­nosed with IBD be­tween 1999 and 2010. The five prov­inces — Al­berta, Man­i­toba, On­tario, Que­bec and Nova Sco­tia — ac­count for al­most 80 per cent of Canada’s pop­u­la­tion.

Benchi­mol said that in most prov­inces the rate of new IBD di­ag­noses in chil­dren un­der 16 was rel­a­tively sta­ble, at about two per cent per year. Still, over the al­most two decades cov­ered by the study, that in­cre­men­tal an­nual in­crease means the over­all num­ber of kids liv­ing with Crohn’s or col­i­tis has jumped by about 60 per cent.

“Whereas the rate in which chil­dren un­der five years old rose was about seven per cent per year — and that was very highly sig­nif­i­cant,” he said.

An es­ti­mated 600 to 650 Canadian chil­dren are di­ag­nosed with IBD ev­ery year, and al­most 3,000 chil­dren un­der age 16 are cur­rently liv­ing with the dis­ease.

The ex­act cause of IBD isn’t known, but re­searchers be­lieve a com­bi­na­tion of pre­dis­pos­ing ge­net­ics and en­vi­ron­men­tal fac­tors is likely to blame. They hy­poth­e­size that al­ter­ations in the bac­te­rial com­po­si­tion of the gut from early ex­po­sure to an­tibi­otics, eat­ing the typ­i­cal high-fat, su­gar-rich North Amer­i­can diet, and low lev­els of vi­ta­min D may trig­ger the dis­ease.

Jen­nifer Klatt’s son Matthew O’Hal­lo­ran be­gan de­vel­op­ing symp­toms, in­clud­ing bloody di­ar­rhea, just be­fore his sec­ond birth­day. He was even­tu­ally di­ag­nosed with Crohn’s dis­ease.

“When Matthew was young, he did have an­tibi­otics sev­eral times for ear in­fec­tions,” re­called Klatt, a teacher in Brockville, Ont. “That could have been a trig­ger.”

Now 15, Matthew con­tin­ues to takes med­i­ca­tions and is care­ful about his diet to pre­vent IBD flare­ups, which can lead to ac­tiv­ity-dis­rupt­ing chronic di­ar­rhea and other symp­toms, said Klatt.

“He’s just got to the age now where he knows if he does some­thing, he is go­ing to pay the con­se­quences,” she said of eat­ing cer­tain foods that can ig­nite the in­flam­ma­tion.

“He is go­ing to have more fre­quent bath­room trips. He’ll have cramp­ing, bloat­ing and gas — all the dif­fer­ent signs and symp­toms,” said Klatt, adding that it’s im­por­tant to be open about the life-al­ter­ing ef­fects of IBD, which af­fects an es­ti­mated 250,000 Cana­di­ans.

“It’s a dis­ease that’s kind of an em­bar­rass­ing dis­ease, which is why we talk about it and why we want to ed­u­cate peo­ple to re­move some of the stigma.”


Jen­nifer Klatt and her 13-year-old son Matthew O’Hal­lo­ran, who suf­fers from Crohn’s dis­ease, pose for a pic­ture in Brockville, Ont.

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