New and terrified

[Sb1980]

My son is 6 and had 2 bloody stools when he was 3, 1 in April of this year, and 3 in the last 3 weeks. He has no pain associated with his stools. No diarrhea. A few random low grade fevers over cold and flu season. He is on the small side, but has never lost weight and is a good eater. Very active.

Ped GI did a colonoscopy expecting to see a polyp and was shocked to find inflammation. He said the inflammation pattern matches Crohn’s. Pathology says it is allergic colitis. GI says he’s never seen allergic colitis that looks like this and is convinced it’s Crohn’s. He did say it’s the most mild case of Crohn’s he’s ever seen. He is having pathology go through and make deeper cuts of the ulcer for a more conclusive result.

I know nothing is certain when it comes to Crohn’s but he said one thing that I can’t get out of my head: kids who have Crohn’s tend to get more extreme symptoms quicker than adults with Crohn’s. Is this true? I’m so heartbroken and depressed to think that my sweet boy who is full of life would have extreme symptoms. For example, he said he could have diarrhea for a month. Please give me some hope. I am really loosing it.

 

[my little penguin]

Welcome
Tagging Maya142
Crohnsinct
Pilgrim
Farmwife

Sorry your son has a dx
Pathology most of the time won’t check the Crohns box unless they see
Non caseating granulomas -which is only found in 30% of the Crohns cases
Your GI can dx Crohns without pathologist

Please get a second opinion
Big places on US are Boston Children’s
Children’s of Philadelphia
Cincinnati childrens

They will re review your child records and pathology

He should have a capsule endoscopy/MRE to determine extent of Crohns

If your child was ok before
Once on the right meds there shouldn’t be an issue
Woth living life
Ds was dx at age 7
He is now in 9th grade in the fall
Active life
Doing things with his friends etc...

Staying on the “scary meds” is key
They keep the intestine healthy
And have no side effects compared to the mild meds
Kiddie disease can change woth time
And can be more severe
That said
Biologics now reduce the risk /rate of surgery
And have kept my kiddos intestine looking pristine (so normal you would know he had Crohns )

His arthritis by far causes more issues

We are here to help

 

[my little penguin]

Oh and no one has diarrhea fir a month
If your child has it for more than a few days
Our GI orders stool tests and bloodwork
Once infections are ruled out

It is determined if the kiddo needs a scope or just a flare
So prednisone or exclusive enteral nutrition (een is formula only no solids ) is starred


If your child has allergic colitis or Crohns
Een (amino acid bAsed formula - neocate jr or elecare jr) would Fox bkth
When taken for 6-8 weeks
Induced remission similar to steriods

Once food is reintroduced inflammation can come back

Wanted to mention many now believe SC (eosinophilia colitis ) is a precursor for Crohns )

Apfed can explain EC better

https://apfed.org/about-ead/egids/ec/


As well as parents of kids with food allergies

https://community.kidswithfoodallergies.org/forum/gastrointestinal-disorders


Wanted to mention
Allergic colitis is primarily seen in infants due to milk allergy

I would definitely seek a second opinion if they stay with generic allergic colitis dx

Your GI does not need pathology to say it is Crohns
To dx your child woth crohns Disease

Please seek a second opinion.

 

[Sb1980]

Welcome
Tagging Maya142
Crohnsinct
Pilgrim
Farmwife

Sorry your son has a dx
Pathology most of the time won’t check the Crohns box unless they see
Non caseating granulomas -which is only found in 30% of the Crohns cases
Your GI can dx Crohns without pathologist

Please get a second opinion
Big places on US are Boston Children’s
Children’s of Philadelphia
Cincinnati childrens

They will re review your child records and pathology

He should have a capsule endoscopy/MRE to determine extent of Crohns

If your child was ok before
Once on the right meds there shouldn’t be an issue
Woth living life
Ds was dx at age 7
He is now in 9th grade in the fall
Active life
Doing things with his friends etc...

Staying on the “scary meds” is key
They keep the intestine healthy
And have no side effects compared to the mild meds
Kiddie disease can change woth time
And can be more severe
That said
Biologics now reduce the risk /rate of surgery
And have kept my kiddos intestine looking pristine (so normal you would know he had Crohns )

His arthritis by far causes more issues

We are here to help

What are considered “scary meds”? GI wants to put him on immune suppressants and said it won’t actually make him sick more
often which makes no sense to me.
Glad to hear about your son. If my son has minimal symptoms does that bode well for remission?
Also, how often should I expect to have him get invasive procedures? He is getting an MRE (is this the same as an MRI?) in two weeks. He had blood work done today and only filled up like 1 of the 7 vials. They told me he needed to be more hydrated next time? Poor baby was so upset after getting two pokes. We are going on vacation tomorrow and I have no idea what to feed him. Gluten free? No diary? SCD? So stressed.

 

[Maya142]

I would also get a second opinion. Some of the big pediatric IBD centers will do a records review without you actually traveling. The big three are the ones MLP mentioned - CHOP, Boston Children's and Cincinnati Children's. If you do want to travel, CHOA (in Atlanta) has a good reputation and is closest to you.

As for symptoms, it really varies. There are kids who have very extreme symptoms when they are diagnosed - bloody diarrhea etc. But there are MANY kids on here who had fairly mild symptoms or subtle symptoms - things like being tired all the time or very gradual weight loss or growth delay.

My daughter was diagnosed after several months of abdominal pain, some weight loss and occasional constipation. She has a type of juvenile arthritis which is associated with IBD and that is why we scoped her. Otherwise I bet she wouldn't have been scoped at all until she got worse. We really thought we were ruling out Crohn's and were shocked to hear she had inflammation and ulcers in her colon, and an inflamed terminal ileum.

As for extreme symptoms - the whole point of medications is to prevent them. Our kids are lucky in the sense that they have access to very effective medications which have really changed the way IBD is treated. Now pediatric GIs like to treat aggressively with the "stronger" meds (more effective) and get the child into remission quickly, before any damage is done and to avoid complications like strictures, abscesses, fistulae etc.

There is a very steep learning curve when your kiddo is diagnosed with a lifelong disease. The first year is typically hardest as you try to find your new normal. But you will find it and things will settle down. Hang in there!!

 

[Sb1980]

Oh and no one has diarrhea fir a month
If your child has it for more than a few days
Our GI orders stool tests and bloodwork
Once infections are ruled out

It is determined if the kiddo needs a scope or just a flare
So prednisone or exclusive enteral nutrition (een is formula only no solids ) is starred


If your child has allergic colitis or Crohns
Een (amino acid bAsed formula - neocate jr or elecare jr) would Fox bkth
When taken for 6-8 weeks
Induced remission similar to steriods

Once food is reintroduced inflammation can come back

Wanted to mention many now believe SC (eosinophilia colitis ) is a precursor for Crohns )

Wanted to mention
Allergic colitis is primarily seen in infants due to milk allergy

I would definitely seek a second opinion if they stay with generic allergic colitis dx

Your GI does not need pathology to say it is Crohns
To dx your child woth crohns Disease

Please seek a second opinion.

Will definitely be getting a second opinion once we have all his lab work complete. GI is saying he’s pretty sure this is Crohn’s. Are you saying that he could potentially go on EEN or prednisone if he’s having severe diarrhea or just for upkeep?

GI was also saying that 50% of cases of allergic colitis turn into Crohn’s. He never had a reaction to foods throughout his infancy, so allergic colitis seems strange. What sticks out to me in the article above is that he did have pinworms a few years back.

 

[Sb1980]

Is it naive to hold on to hope? His symptoms are mild as is his inflammation. Could he just stay in remission for a long time with immune suppressors?

 

[my little penguin]

So immunosuppressants are 6-mp/ Imuran and methotrexate
Ped GI no longer use 6-mp and Imuran since they are linked to high risk of lymphoma
Instead they use methotrexate(mtx) which does not have that risk

Mtx if you google says chemo therapy drug
Which is true if you takes it at extremely high dose (think in thousands )
Versus Crohns dose is about 7-25 mg so tiny
Juvenile arthritis kids as young as 2 take mtx
Ds has been on mtx for over 5 years with other meds

Een and or steriods are used to induce healing
That way the maintenance med can take over and keep the inflammation away
Methotrexate takes 8-12 weeks to work
So you start the pred /een at the same time as mtx
Then wean off the een

Given your kiddos age
I would ask about exclusive enteral nutrition
No side effects and little kids don’t know that they can tell mom NO yet
Otc formulas like pediasure or kids boost can be used
But some need semi elemental formula like peptamen jr or peptide
The semi elemental can be covered by your insurance under your durable medical equipment clause as infusion therapy supplies
It’s not covered by prescription plan
Most durable equipment companies have insurance specialists that can help get it covered

He would be drinking 7-8 shakes a day with no food for 6-8 weeks
It is difficult not to eat
But does heal the gut

Ds has done een many times
Hates it but loves how it heals the gut
After his first een of 9 weeks at age 7
We kept him in formula (peptamen jr) 2-3 shakes a day for years
He now drinks 50% of his calories from neocate jr chocolate (amino acid based elemental formula )
By adding extra formula but allowing food
It has allowed Ds to grow similar to his peers
He grew 5 inches last year and is expected another 5 this year
To end up being close to 6 ft tall at age 15

Bring under weight and not growing is common in Crohns but can be avoided with formula

Better to start young

MRE is the same as an mri
It’s a special mri woth entrography used for crohn
You drink barium to coat the intestine so they can see them better
They also give contrast (glycogen and gallulidium) during the scan
Pediatric hospitals have movie googles which sometimes can be used for little kids

 

[Sb1980]

Thank you. This is all very helpful and very scary. So it seems like EEN + mtx is what you are suggesting. With this combo, could he stay in remission for a long period? Once he can eat, then it would be the SCD?
Like I mentioned, we are going on vacation this week and I’m terrified his inflammation will get worse once we are gone. Given that his Crohn’s is mild, could it get severe enough to have bad symptoms in a weeks time? Again, he’s only had a handful of bloody stools, great energy, no weight loss. Are we safe for the week? I’m so scared.

 

[Maya142]

Well none of us has a crystal ball (but we all wish we did!) but I wouldn't expect things to change significantly in a week. If he's feeling good, I would expect him to continue to feel good. At worst, I'd expect a flare - in his case that currently means more bloody stools. With those, he may have belly pain and other symptoms or he may not. Honestly, no one can tell you how the next week is going to turn out, but my best guess is that it will be the same as last week.

As for medications, we can't tell you what he should be on. Only his GI can tell you that. We CAN tell you that in most cases of pediatric Crohn's, the child does need an immunomodulator (either MTX or 6MP) at least to maintain remission. Many kids need a biologic either in combination with MTX/6MP or by itself.

EEN or steroids are usually used to induce remission. Both induce remission, but steroids do come with side effects -- puffy face, weight gain, moodiness, increased appetite and in the long-term can have nasty side effects, which is why they are used only when necessary. But they are very effective at getting rid of inflammation.

EEN doesn't really have side effects, except that it can be hard psychologically on the kiddo to not eat for 6-8 weeks. Some kids drink the formula, others use NG tubes (mine did). It is easier for younger kids typically (vs. teenagers). And EEN is better for mucosal healing than steroids are.

Try not to panic - life will change but it won't necessarily change a lot. Most kids, once they find the right combo of meds, can live very normal lives. They play sports, participate in choirs, play instruments, volunteer and so on.

 

[Pangolin]

EEN is currently working for my son. If it works for you, I'd recommend not simply switching back to a normal diet after 8 or 12 weeks. Be careful and make sure that foods you reintroduce aren't causing a problem. Here's my thread on een https://www.crohnsforum.com/showthread.php?t=83930

 

[Tesscorm]

I'm very sorry you've had the need to find the forum. I can sense your fear and uncertainty and it very much brings back the confusion and fear I felt when my son was diagnosed. As was said above, the first year is the toughest as far as questions and uncertainties go and in finding your new 'normal'. But, 'normal' will come back, even if it is somewhat different from before. :ghug:

I agree with Maya... while no one can see what will happen next week, probably nothing too much different will actually happen. But, a couple of things to keep in mind while travelling... you just don't want to do something that will upset his tummy (regardless of crohns). If he usually doesn't eat much junk or fried food, then this may not be the week to let him have pizza and fries every lunch or dinner, don't let him be picking at a buffet all day - ie eating more than he usually would at home, have him drink bottled water only and no ice in other drinks (if you're going to the caribbean, mexico, etc.), basically, try to keep him on the same types/amounts of food as at home (a little bit of junk likely won't hurt him though! ). None of this stuff will actually cause/trigger crohns, however, if he suddenly develops any tummy/intestinal issues, you will panic, worry it's crohns-related, etc. ... so these suggestions are simply 'travel' suggestions.

The first few times my son went on vacation, after diagnosis, I had him take nutritional shakes (ie Boost) or Carnation Breakfast powder (weighs less in suitcase). It was my back-up in case he became ill and wouldn't/couldn't eat... at least he'd be able to 'drink' some nutrition. (It was never needed! )

On the way to my son's first hockey tournament after diagnosis, he told me he was having some pain and hadn't had a BM in a couple days! I was so scared... thought he was having an obstruction or flare, ... it was one of the parents here who kept me 'balanced' and suggested I simply treat the 'constipation' naturally, regardless of crohns... I went out and bought yoghurt, prune juice and coffees... poor kid, I made him have all of it... :lol: even though he'd never had coffee nor prune juice! Anyway, it solved the problem. Anyway, my point is that once you've had this diagnosis, it leaves you vulnerable and you immediately worry about everything (we've all been there!). Try to enjoy your vacation and expect nothing new next week. But, at the same time, just watch what he eats and avoid foods that can upset his tummy. Of course, keep an eye for anything unusual and come to forum for some reassurance when you need to! But, have fun!!

Do not give him nsaids (advils, etc.)... if he should require pain meds, etc., use Tylenol. Nsaids are not usually recommended for people with crohns. (This applies always... not just while away . )


Re your question on SCD. Once he is in remission, no special diet is necessary. Some people have sensitivities or intolerances to certain foods (dairy, fatty, high fibre, etc.), so these foods are avoided (sometimes elimination diets are tried to determine what foods trigger symptoms). Sometimes diet can be used to reduce symptoms (ie rice for diarrhea, prune juice for constipation). But, aside from this, once in remission, a regular diet will not usually trigger a flare.


:ghug:

 

[my little penguin]

Yeah that ^^^
Een is short term longer term can caused psychological issues
Partial een (food plus formula )
8 years - healthy normal looking intestine and no scd or special diet due to Crohns
He takes his Stelara plus mtx
He also drinks formula (delayed gastric emptying ) with his solid food


Crohns kids only need to avoid nuts /popcorn and seeds
Otherwise diet isn’t necessary

They just need meds

Adults have a different phenotype of Crohns
Than kids
Some adults have success with diet only as treatment such as paleo or scd

The big pediatric ibd centers children’s of Philadelphia etc...
Do NOT recommend SCD for kids
It limits the diet too much and doesn’t let them get enough calories.

Your GI will guide you on what is the best treatment for your child based on their experience and your child’s history
Not based on the internet forums
We can just tell you our kids stories.

Also remember the majority of the moms here stay around since their kids are more complicated than the average Crohns kid
The rest of them pop in their kiddo gets good meds
And move in with lifebever to be seen again
Which is great.

My kiddo is complicated
Not so much Crohns but arthritis side
So that’s why we are still here

 

[my little penguin]

See NEW guidelines I just posted
Just released
Wow
Things are changing

 

[DanceMom]

"Immune suppressing drugs" sounds scary but they've been life changing for my girl. She does not have Crohn's, but does have a rare GI disease and an immune deficiency. She's been on a fairly high dose of Cellcept with zero side effects and does not get sick more than any other kid her age. Get a second opinion, ask lots of questions, and be the best advocate you can be for your little guy!

 

[Maya142]

Yes - we go to one of top 3 IBD centers and they said that they don't recommend the SCD, simply because kids tend to lose weight on it because it's so restrictive. If you do want to try diet and not meds, then they prefer the IBD AID diet (less restrictive). They also say to give diet a set amount of time to work - i.e. 6 weeks, and if it does not work based on Fecal Calprotectin or other inflammatory markers, then to move on.

At our hospital EEN is very big, but only for a short period of time, usually 6-8 weeks. After that you move to supplemental EN where a certain number of calories are from food and a certain number come from formula, which either the kiddo drinks or it goes through the tube.

My daughter was diagnosed at 16 and found EEN very hard and got very depressed. So we moved to supplemental EN and that was much easier on her. Little kids tend to do better with EEN, but very few can manage it indefinitely. It is much easier on the child when there is an end date. But every kid is different.

Also, do not be afraid of a feeding tube if your child is unable to drink formula. We were and I think we really just scared my daughter about it and made her even more anxious, when it turned out not to be a big deal at all. She inserted a feeding tube (an NG tube) nightly and pulled it out in the morning before school. The first few days were tough, after that she could do it in 10 seconds!!

Also, I second what Tesscorm said about traveling and diet - try to keep junk food to a minimum because it may upset your son's stomach. We try to keep my daughter's diet as similar to home as possible when we are traveling, to avoid diarrhea and tummy aches.

 

[Sb1980]

Re:EEN and the feeding tube—would you do all her EEN at night and then she wouldn’t eat during the day? Wouldn’t she have to go to the restroom or get too full if you did it all at night?

 

[my little penguin]

For her age most use feeding tubes during the day
Only teens use it at night and pull the tube in the morning
Then re insert at night

Realize the majority of little kids can drink their een orally
It’s not easy but After a few days and few tears
They can chug it down in 30 seconds
We did a sticker chart
And paid Ds money for each week of een
He got a big toy at the end

Straws
Very cold
And lids help
Ds drank two shakes for breakfast
Lunch and dinner plus snack
Eight a day
He would bring hydroflasks to school with shakes
For lunch
The kids couldn’t see it
He told them he was on muscle building protein shakes
:lol:
Which the other 7 years old loved

We did food free birthday
And other holidays no foods
It can be done
Easily without a tube for little kids

Teenagers are a different ball of wax

Little kids get too hungry otherwise since they burn calories. Faster than older kids

She may tolerate pediasure as her een
Or kids boost
A lot of kids do

 

[Tesscorm]

My son was older when he did six weeks of EEN, so he had a better understanding/appreciation of the need to be complliant. He used the NG tube and ingested his formula overnight (no, he did not need the bathroom overnight). However, he did get hungry by dinner. Distraction is what helped him BUT he was almost 17 and understood why he needed to 'go hungry' so to speak. Doing it only overnight, I think, would be tough with younger children.

A couple of options to consider, if you try EEN... my son was allowed clear fluids along with the formula. This meant he could have broth at lunch, with friends. He could also have a bowl of broth as 'dinner'. And he was allowed freezies, gummies, jello... this all helped a little bit when he was hungry.

Also, your son would need to take in a minimum number of calories. Sometimes this equates to quite a few shakes in a day. If he is really unable to drink all the necessary shakes and he would accept/tolerate having a tube, it might be possible to have him drink as much as possible during the day, to control hunger, and then, if he can't have it all, finish off the required formula overnight through the tube. I don't know how this would affect your insurance coverage (if it even has an impact) and it means that you'll be taking on two struggles - convincing him to drink the shakes and convincng him to have the tube inserted.

For my son, even being older, he much preferred the tube... he wasn't offered the option to 'drink' when this treatment was first proposed and, after I learned more and told him there was an option to drink the shakes, he did not want to be 'obligated' to drink a minimum number of shakes. The tube can be very convenient (if your son is open to that idea).

Usually, younger children keep the tube inserted throughout the day (it's only removed every few weeks). It is a thin tube and is taped to their cheek to keep in place during the day (of course, it's not hooked up to the pump during the day). Just something to consider...

 

[my little penguin]

Usually, younger children keep the tube inserted throughout the day (it's only removed every few weeks). It is a thin tube and is taped to their cheek to keep in place during the day (of course, it's not hooked up to the pump during the day

Most little kids who have tubes are hooked up to a pump they carry with formula in a backpack during the day
They can’t go that long without food which is why little kids are scopes first thing in the morning and teens are late in the afternoon

Big difference
But either way some can drink it all
Others drink some /then some
And then some tube it all
But it’s an all day thing for little kids
Their bodies can’t go that longer without food
To only tube at night

 

[Tesscorm]

I was actually thinking a combination of the two, day and night. While S ingested his formula only through the tube (his formula was elemental, so not 'drinkable' taste-wise), there were a couple of instances when he was going to be home late, so not enough time overnight to run all the formula. In those instances, he ran the pump with the formula for a couple of hours after school and then finished the balance overnight.

What I was suggesting is, if it's too hard for a child to drink all 8 shakes (or whatever the quantity that is required), and if the child is amenable to having the tube, you can avoid the fight to have him drink all 8 every day... he could drink 6 during the day and finish the balance overnight???

I hope I wasn't creating more confusion!! EEN has so many benefits, it would be a shame to have to stop because of non-compliance... was just suggesting a way that might facilitate compliance.

 

[Maya142]

If you're doing EEN then the kiddo would need to be hooked up to a pump during the day and would carry it in a little backpack. When my daughter needed 1800 calories through her tube, and was at a 100 mL/hr rate, she needed to be hooked up most of the day (18 hours). It depends on the rate your child tolerates.

But if you're doing supplemental EN and the child is eating during the day, then the kiddo is only hooked up at night.

You can also do a combination of day and night like Tess said - if the kiddo is hungry during the day, he/she drinks a few Boosts. Then you make up the rest of the calories at night with the tube/pump. That way the kiddo isn't hungry during the day.

But like has been said, I would first start with trying to get your kiddo to drink all the shakes. You may be surprised - many kids manage to do it. Pediasure and Boost kids are the most palatable formulas. These are called polymeric formulas.

If your child doesn't tolerate those, that's when it gets harder. Then you would try a more broken down, semi-elemental formula that is easy to digest. Something like Peptamen Jr or Pediasure Peptide. These taste worse. Our GI actually only uses semi-elemental formulas for kids with IBD - she says kids with IBD tend not to be able to tolerate polymeric ones (like regular Boost, Ensure or Pediasure).

Based on what I've read on the forum, there are kids who can tolerate polymeric formulas like Boost. But not all can - my daughter had diarrhea when trying Ensure and Boost. So we had to go to semi-elemental which she tolerated in small quantities to elemental.

Elemental formulas are the most broken down - into amino acids. They are easy to tolerate. The downside is that they taste awful. My kiddo tried her very best to drink Neocate but just couldn't get enough down. So that's when we went to a tube. Our GI said most teenagers are unable to drink elemental formulas and even school age kids tend to have trouble and need the tube. But little kids are able to drink them (mostly because they don't know any better).

But what I have learned as it really varies and depends on the kid.

So your kiddo's ability to do EEN may also depend on the kind of formula he needs. If you can get away with regular Boost/Pediasure/Ensure, then he is likely to have an easier time. If you have to do semi-elemental or elemental, it might be harder to get him to drink. Some kids are able to drink elemental but most aren't.

 

[Maya142]

Re:EEN and the feeding tube—would you do all her EEN at night and then she wouldn’t eat during the day? Wouldn’t she have to go to the restroom or get too full if you did it all at night?

My daughter did supplemental EN at night. She never did EEN - the the closest we got to EEN was 85% formula and 15% food. But anyway, when she was getting 85% formula, she was hooked up to the tube for about 18 hours a day.

When she was getting something like 50% formula, then we'd do it all at night. You are able to control the rate of the pump, so we kept it slow so her stomach wouldn't feel too full. If I recall correctly, initially she went to the bathroom a few times at night but as she got used to it and we found a formula that suited her better (an elemental formula - Neocate Splash) that stopped.

 

[Maya142]

I also want to add that if you are going to be doing supplemental EN for years because your child needs the extra calories to gain weight and grow, doctors will often switch from an NG tube that is inserted into the nose, to a G tube which is surgically placed in the stomach. My daughter has one of those now (and a J tube which goes into her small bowel, but that's for a different illness - Gastroparesis) and likes it MUCH better than the NG tube. It it a tiny button (you can google Mickey Button g tube) and it does not show through her clothes at all.

Alternatively, some kids are able just to drink shakes for the time that they really need those extra calories.

 

[my little penguin]

One last secret
If your trying een
Get free samples of everything fro
The GI office
Nestle nutrition/nutrica nutrition or Abbott nutrition

Have your child taste the worst elemental formula first
They try semi elemental peptamen jr or peptide

Similar to giving a baby veggie before fruit
If they taste the worst
The other formulas including semi elemental taste “good”
Also know that they may not like the formula for a few days
Then their taste buds get used to it
No issues for that brand

Chocolate covers most tastes
Our GI permitted Aaah Alaska chocolate syrup to be added to the peptamen jr shakes
Our durable medical equipment company only carried vanilla
And Ds hates vanilla
Added choc syrup he drank it fine
After a year we stopped adding syrupsince he was ok with vanilla at that point

 

[Sb1980]

Are you hopeful for the MAP vaccine?

 

[my little penguin]

Map is only one of many many theories over the decades
It doesn’t explain why kids have different phenotypes and genetics than the adult version of Crohns
Map vaccine would only help those adults who have not been already infected with map
Whether map causes Crohns in adults is a different matter since the vaccine wouldn’t help there.
Similar to the chicken pox vaccine you only give the vaccine to prevent folks from getting the chicken pox
But don’t give the vaccine to folks who already had chicken pox

Crohns in kids under age 10 is considered early onset ibd which is a different phenotypes than pediatric Crohns age 11-17
And under age 6 is extremely rare -considered very early onset ibd

This is different from the other two types of kiddie Crohns and how it behaves

Unfortunately Crohns is not one size fits all
Many different versions under the same name
Hence the confusion