Inflammatory Bowel Disease in Infants

Yes, long-standing acid reflux can raise the risk of esophageal cancer, but only in a small fraction of patients. About 10 to 20 percent of chronic GERD patients develop Barrett’s esophagus, and roughly 0.5 percent of those progress to esophageal adenocarcinoma each year. Early treatment changes that risk dramatically.

According to Dr. Ksheetij Kothari, a senior Gastroenterologist in Pune, “Persistent bloody diarrhoea, poor weight gain, and recurrent perianal infections in a baby under 2 should never be dismissed as routine colic. The earlier these patterns are evaluated, the better the long-term outcome.”

Specialised investigation usually involves paediatric-friendly endoscopic services carried out in close coordination with the child’s paediatrician.

The early signs of IBD in infants can mimic common digestive complaints. The difference is they don’t settle with routine treatment and tend to worsen over weeks.

• Persistent diarrhoea:Loose stools more than 5 times a day for over 2 weeks
• Blood or mucus in stool:A red flag at any age, even in small amounts
• Failure to thrive:Poor weight gain, weight loss, or falling off the growth curve
• Recurrent fever:Low-grade fever lasting weeks without obvious infection
• Perianal disease:Skin tags, fissures, abscesses, or fistulas around the anus
• Abdominal distention:Persistent fullness that doesn’t ease with feeds
• Feeding difficulties:Refusing feeds, vomiting after meals, or sudden irritability

One thing worth mentioning: a baby who looks unwell between feeds and falls off the growth chart is telling you something. Tracking weight monthly and noting any blood in the diaper is more useful than waiting for a textbook presentation. Some symptoms also overlap with intestinal worms in children, which a paediatrician usually rules out early.

Diagnosing IBD in infants needs a careful mix of clinical history, lab work, imaging, and endoscopy. A single test rarely confirms the diagnosis on its own.

• Blood tests:Anaemia, raised inflammatory markers (CRP, ESR), and low albumin point to active disease
• Stool studies:Calprotectin levels, infection cultures, and parasite tests help rule out other causes
• Genetic testing:Recommended for infants under 2, since many VEO-IBD cases involve single-gene mutations like IL-10 receptor defects
• Upper GI endoscopy and colonoscopy:Direct visualisation with biopsies remains the gold standard
• MR enterography:Cross-sectional imaging to assess the small bowel without radiation
• Specialist immunology review:Helps identify rare immune deficiencies that mimic or trigger IBD

Colonoscopy with biopsy is central to confirming the diagnosis. Parents can read more about the colonoscopy cost in Pune page before discussing options with the care team.

Here’s a quick guide to what’s checked at each diagnostic stage:

IBD in infants is a long-term condition, but most children grow up to live full lives with the right care plan. Management rests on three pillars: nutrition, medication, and family support.

• Nutritional therapy:Exclusive enteral nutrition (EEN) using special formulas can induce remission in 60 to 80 percent of cases without steroids
• Medications:Aminosalicylates, immunomodulators, biologics like infliximab, and in select cases, antibiotics
• Growth monitoring:Monthly weight, height, and developmental checks keep treatment on track
• Vaccination planning:Live vaccines need timing around immunosuppressive therapy
• Surgery in select cases:Strictures, fistulas, or unresponsive disease may need bowel-sparing surgical intervention
• Family counselling:Parents need education on red flags, diet adjustments, and emotional support

Confirmed cases benefit from structured inflammatory bowel disease treatment plans tailored to the child’s age and disease severity.

Patients across Pune trust Dr. Ksheetij Kothari for complex IBD evaluation and post-diagnostic gastrointestinal care due to his advanced endoscopy and biopsy experience and attentive follow-up. Recognised at the International Healthcare Awards 2022, he works closely with paediatric specialists when infant cases need joint care.