DaytonDailyNews.com

Q: My 15-year-old is suffering suffering from occasional bouts of pain in her abdomen and during bowel movements. Is it just a stomachache?

A: Abdominal pain, diarrhea and painful bowel movements are warning signs of inflammatory bowel disease (IBD). Nearly 1 million Americans have IBD. But, because these symptoms can come and go, many people ignore them as just another stomachache. If it is IBD, ignoring these symptoms can actually aggravate the condition and lead to serious health issues.

IBD refers to chronic inflammatory disorders involving the gastrointestinal tract. Ulcerative colitis and Crohn's disease, subsets of IBD, can occur at any age, but they are most prevalent between the ages of 15 and 30.

The causes of IBD are unknown but we know there is a genetic predisposition so if your sibling has IBD, your risk increases. Environmental triggers are also a factor. Intestinal infection and exposure to medication can trigger an initial inflammation that the body simply cannot heal. It's known as a chronic disorder because the inflammation just keeps going.

Symptoms of ulcerative colitis — which affects only the large intestine — include blood in the bowel movement, diarrhea and painful bowel movements. Although the condition is chronic, the symptoms are not. The issue with children is that they won't tell their parents unless it really bothers them so it's common for ulcerative colitis to persist in children for months without treatment.

Crohn's disease can affect any part of the gastrointestinal tract. Symptoms depend on where the inflammation occurs. Pain high in the abdomen, vomiting, loss of appetite, diarrhea and weight loss are all symptoms of this disease. Like ulcerative colitis, Crohn's can cause painful bowel movements, diarrhea and blood in the stool. In some cases, stunted growth is the only symptom of Crohn's. The red flag is if it is associated with stomachaches. The inflammation prevents the body from responding to growth hormone.

Medical diagnosis of IBD begins with a complete physical exam and family history. Blood tests, stool cultures, X-rays and other tests might also be performed to support a diagnosis of IBD. To make a definitive diagnosis and to determine whether the condition is ulcerative colitis or Crohn's disease almost always requires performing a colonoscopy and upper endoscopy. This involves examining the lining of the bowel through a flexible tube with a bright light on the end.

Treatment for IBD varies from person to person. For most, the initial treatment involves prednisone steroids, which decrease inflammation. Then, anti-inflammatory drugs are prescribed. If symptoms are severe, a physician might prescribe drugs that suppress the immune system.

Surgery is needed if symptoms are very severe and do not respond to other treatments. Ulcerative colitis can be cured by surgically removing the colon. There is no cure for Crohn's disease, but surgery is often required to mend holes or tight areas in the bowel.

Although the symptoms might vary over time, ignoring them can result in serious health issues.

It's important to recognize and diagnose these diseases as soon as you can because they can have long-term consequences, such as stunting of growth. They can impact quality of life significantly. Fortunately, with care and medication, people who have IBD can manage the symptoms and lead active lives.

M. Susan Moyer, M.D., is a medical director focusing on inflammatory bowel disease (IBD) and complex nutrition problems related to gastrointestinal disease. Much of her presentations and published articles focus on IBD, infections of the biliary tract, acute pancreatitis, viral hepatitis, gastritis, pancreatitis, celiac disease, infectious agents, oncogenesis and antibiotic-associated diarrhea. She sits on the editorial board for Journal of Clinical Gastroenterology and was awarded 2005 best doctors by Cincinnati Magazine. Dr. Moyer plans to practice at Cincinnati Children's Liberty Campus in addition to her current roles on main campus.