Reporting of side effects: If your child experiences any side effects, talk to their doctor, pharmacist or nurse. This includes any possible side effects not listed in the package leaflet. You can also report side effects directly via the Yellow Card Scheme at www.yellowcard.mhra.gov.uk or search for MHRA Yellow Card in the Google Play or Apple App Store.
What is IBD?
Inflammatory bowel disease (IBD) is a term that describes disorders that involve a chronic (persistent) inflammation of the digestive system.
This can cause symptoms including diarrhoea, rectal bleeding, stomach pain, fatigue and weight loss.(1)
IBD commonly refers to two disorders - Crohn’s disease and ulcerative colitis.
What’s the difference?
The two share common symptoms but there are some key differences:
Crohn’s Disease
Crohn’s can affect any part of the digestive system. It appears as inflammation, sporadically, with healthy areas between the inflamed spots.(2) Crohn’s is often marked by nausea, weight loss, vomiting and anal bleeding with other symptoms including mouth sores or inflammation of the eyes, joints and skin.(3)
Ulcerative colitis (UC)
While Crohn’s may affect any part of the digestive system, children who develop UC are affected by sores, which appear only in the inner most lining of the large intestine and rectum. Tell-tale signs of UC include blood in stool with mucus, diarrhoea and tenesmus, the sensation of needing to go to the toilet but without having a bowel movement.(3)
What causes IBD?
Our bodies protect us from harmful substances such as viruses and bacteria by recognising proteins on these foreign bodies called antigens.
When our bodies detect antigens somewhere they shouldn’t be, our immune system will attack and destroy them to keep us safe.(4)
However, our digestive system is constantly exposed to new antigens that are found in bacteria and the food we eat, so our bodies tell our immune system not to worry about the antigens in our gut because they’re allowed to be there. This is called “gut homeostasis”.(5)
We don’t fully understand why, but in a person with IBD, their body does not understand that it’s fine for the foreign bodies to be in their digestive system and instead tries to fight them off.
This is what causes inflammation of the gut and the other consequential symptoms such as rectal bleeding and weight loss.(6)
Your genes might play a role in the likelihood of you developing IBD.(1)
Taking your medication
Your child’s doctor will have prescribed medicine to manage their IBD. Treatment depends on how severe your child’s symptoms are, and the extent to which their gut is affected.(7)
Initially, the medicine your child is prescribed will aim to reduce inflammation in the gut to bring about remission. When your child is in remission, it means that they’re starting to feel better, and their symptoms aren’t bothering them. This is called induction treatment.(8)
Following induction treatment, your child will usually be prescribed drugs to keep them feeling well and prevent their symptoms coming back (known as relapse). This is called maintenance treatment.(8)
It’s very important you encourage your child to take their medication as directed by their doctor. It’s essential you and your child attend all appointments to ensure the medicine is working correctly and isn’t causing any side effects.
Flare-ups
Sometimes, even when your child is taking their medication as planned, symptoms can come back and make them feel unwell. This is called a flare-up.(9)
If your child experiences persistent tummy ache, fever, vomiting, diarrhoea, blood in their poo, weight loss, or general ill health, then we recommend getting in contact with your child’s physician. Your child’s doctor can help provide you with the support and guidance necessary to manage your child’s symptoms. You can also work with your child’s IBD team and create a flare plan so that you know whom and when to contact if flare-ups occur.(9)
One of the most common triggers of IBD flare-ups is stress.(9) It’s therefore important to take note of changes in your child’s emotions and understand how stress manifests in your child. You can use our Medication Diary to take note of any emotional changes your child may be exhibiting before or during their flare-ups so that you can be more aware of potential triggers going forward.
Flare-ups can be prevented by encouraging your child to follow their treatment plan.(9)
Advice for parents
How do I encourage my child to take their medication?
Getting your child to adhere to their treatment can be difficult. One of the best ways to help them to understand the importance of their medicine is communicating through love and emotional support. When it comes to their pain and symptoms, making sure they take their medicine and do not regularly miss doses is incredibly important.(10)
Here are some tips that may help if your child is struggling with taking their medication:(10)
A positive attitude
Your attitude towards your child’s medication will influence how they view their medicine. You may find it encouraging for your child to discuss the benefits of the medication and motivate them to take it each day.(10)
Help from family and friends
Sometimes, someone other than a parent or guardian can help to encourage your child to take their medicine. This could be an older sibling, grandparents or even a close family friend.(10)
Rewards
Whether the reward is lots of praise, extra TV time or a bedtime story, rewarding your child for taking their medicine will provide them positive associations with taking their medicine and encourage them to continue taking it.
However, your child should also understand that their medication is an important part of their daily life.(10)
Sticker charts
A sticker chart can be a great way to engage children in their own medication routine. You may even find it helps your child to become more independent and take control.(10)
Please ask your healthcare professional for a copy of our children’s activity book
Further support
Please ask your healthcare professional for further clarification on the information given, if required.