Impact of having IBD on teens
DELAYS IN DEVELOPMENT
Inflammation in the gut can affect both appetite and the absorption of nutrients, causing impaired growth. A young person with IBD may look and feel different from their peers – and may find themselves excluded from social activities and treated inappropriately for their age.
EFFECTS OF TREATMENT
IBD generally requires lifelong treatment, which can have unpleasant side effects. Treatment often includes corticosteroids (steroids) to reduce inflammation, and/or drugs that suppress the immune system. These steroids are not the anabolic steroids sometimes used by athletes.
Unwanted side-effects of steroids, especially at high initial doses, can include:
- significant weight gain
- the roundness of the face
- acne
- mood swings, from euphoria to depression
Other unwanted side effects from drugs used to treat IBD may include:
- headaches
- nausea
- flu-like symptoms
- increased susceptibility to infection
While most IBD drugs are taken in tablet form, some treatments involve weekly injections or visits to hospital or clinic for intravenous (IV) drug treatment.
Some young people may be on dietary treatment. This takes the form of a liquid diet consisting of all the nutrients needed. Usually, nothing other than the diet and water are allowed for weeks or months at a time. If they have difficulty drinking the feed, they may take it via a tube inserted through the nose down into the stomach. Once in place, the tube can remain for many weeks. The high concentration of nutrients in the feed can sometimes cause nausea and headaches.
HOSPITALIZATION
There may be times when a student experiencing a severe flare-up of IBD needs treatment in hospital, sometimes lasting several weeks. In very severe cases, badly affected parts of the bowel may need to be removed by surgery. This sometimes involves an ileostomy (surgery to create an opening of the small bowel onto the surface of the abdomen) and wearing a stoma bag to collect waste (feces). Stomas may be temporary but can be permanent.
PSYCHOLOGICAL EFFECTS
Young people with IBD are often at increased risk of depression and anxiety because of the unpredictability of their condition, the feelings of loss of control their symptoms can cause, and the adverse effects of IBD drugs. When chronic pain and exhaustion are ongoing, the student may be unable to concentrate, may feel depressed, and perhaps, in extreme cases, have suicidal thoughts. Although stress is not a cause of IBD, a number of studies have shown that stress is often associated with relapses of the condition. Exams can be particularly stressful and have been linked with flare-ups of IBD.
It can be hard for young adults with IBD to have to cope with the embarrassment of their disease. They may dread having to rush to the toilet, having an ‘accident’, smells and ridicule. They may feel distressed about being much smaller, thinner or less developed than their friends. Or, if they are taking high dose steroids for their treatment, they may become depressed about putting on weight and becoming fatter and round-faced. Changes in their perception of body image can lead to low self-esteem.
Students with IBD may also feel isolated and out of step with their peers due to missing lectures or being unable to join in activities. It can be particularly difficult to cope with the unpredictability of IBD, which might mean feeling perfectly well one day and utterly drained and exhausted the next. IBD is also an unseen condition, which can again be hard to manage. Someone with UC or CD may not look that unwell to others, especially if they are taking steroids, when they are, in fact, feeling awful.