It would be wonderful if all young people could enjoy good health and smooth adjustment during their primary and secondary education years. Unfortunately, some children are diagnosed with chronic illnesses such as Crohn's disease and ulcerative colitis at an early age. Just getting through the school day can be an extremely difficult task without the support and encouragement of teachers who understand their Illness.

What is Inflammatory Bowel Disease

Crohn's disease is a condition in which the wall of the small or large intestine becomes sore, inflamed, and swollen. This causes abdominal pain, diarrhea, fever, and loss of weight. Some young people experience pain in their knees, ankles, and other joints. Crohn's disease is called ileitis when it affects the lower small intestine, Crohn's colitis when it affects the large intestine (colon), and ileocolitis when both small and large intestines are involved.

Ulcerative colitis causes inflammation of the inner lining of the large intestine. For this reason, diarrhea is often mixed with blood and may occur with great urgency to the point of incontinence. There may also be abdominal pain and pain in the joints.

Crohn's disease and ulcerative colitis may occur at any age, even in children under 10 years of age.

All genders are affected equally and IBD is not to be confused with Irritable bowel syndrome. 

Coping With the Disease and its Treatments

The hardest thing for me to cope with was the fact that/was different.

"My disease sort of isolates me from other kids. So it is hard for me to make friends. Deep down I really want to be like everyone else." 

Young people with Crohn's disease or ulcerative colitis must cope with attacks of pain and diarrhea, episodes of fever and nausea, and lack of appetite.

Children with IBD may eat less than their bodies require, which can cause them to grow at a slower rate and may appear younger and smaller than their classmates. 

Absence From School

My biggest problem is that most of my teachers don't think I look sick 

Young people living with IBD may appear quite well but actually feel too ill to attend school. They might also feel well one day and sick the next. The disease and medications cause either fatigue or sleep-lessness, making it difficult for them to keep alert during the school day, and keep up with assignments. An understanding of these patterns helps the child to cope with missed assignments and lost school days.

Many young people with Crohn's disease or Ulcerative colitis require hospitalization from time to time, sometimes for several weeks or even longer. Surgery may be necessary to remove diseased intestine or alleviate a complication.

While in the hospital, they appreciate hearing from classmates and teachers and frequently can keep up with schoolwork and assignments

Leaving the Classroom

Sometimes when I have to leave the classroom, some teachers give me a hard time, and this forces me into explaining my situation. Meanwhile, I am in pain and do not feel I have to explain my condition. 

Young people with IBD tell us that their most difficult problem in school is their need to use the bathroom. Unfortunately for them, attacks of pain and diarrhea may occur suddenly and without warning. Children with Cohn's disease or ulcerative colitis must be able to leave the classroom quickly and without attracting attention.

Questions about their need in front of classmates will only cause intense embarrassment and shame, and even a short delay may cause an accident. When treated like appropriately, the young person will usually respond maturely and will not abuse the privilege of leaving the classroom to use the bathroom.

In some schools, bathrooms are locked for long periods during the day to encourage students to remain in the classroom.  These situations present further obstacles to students needing a bathroom urgently. 

One solution might be to provide a key or a special pass to be used at any time during the school day; another might be to have the student use the bathroom in the nurse's office. These use acknowledge the reality of the problem and show respect for the student's feelings and condition. 

Class Trips

I was never sure what to do about class trips because I never knew in advance how I was going to feel that day. The problem was that the money had to be collected in advance with no refunds. 

Participation in class trips and outings can present problems for a student with Crohn's disease or ulcerative colitis. Attacks of pain, gas, or diarrhea during long bus trips, for example, can cause intense anxiety. Since few young people are willing to impose their requirements for frequent bathroom stops on the whole group, a child whose disease is causing problems may decide to skip the trip altogether.

Make sure to chat with the student with IBD to draft a plan of action, sometimes planning bathroom stops and knowing where bathrooms are on route to your location will help the student. 

Taking Medication During School Hours

Students with IBD often need to take medications during the school day to help control their condition. Ongoing communication between teachers and the student will make this routine easier and ensure they can take the medication discretely especially if it requires to be taken with food or outside of the classroom.

Participation in Sports

Young people with these illnesses should be as active as they would like to be. They can participate in sports if they feel well enough.

However, some strenuous sports may cause fatigue or aggravate abdominal or joint pains. If this happens, modified exercise may be the answer. Teachers can usually work closely with parents and the child's physician in developing an individualized program. If the student has had recent surgery, their surgeon will make the determination when it is safe to resume activity. 

Some Facts You Should Know

Crohn's disease and ulcerative colitis are lifelong illnesses. Medications often alleviate inflammation and discomfort, but do not cure the diseases.

Crohn's disease and ulcerative colitis are not caused by emotional stress.

Young people with these illnesses need the support of teachers as well as family and friends in order to cope.

Most children do not need special diets. They can generally eat what their classmates eat, although they may avoid certain foods which cause them discomfort. However, when the disease is active, they may be more selective in their food intake.

Young people with Crohn's disease and ulcerative colitis need ready access to a bathroom. Diarrhea is often a severe problem, and getting to the bathroom in time can be a great source of anxiety.

Young people with Crohn's disease and ulcerative colitis need our understanding and support in order to develop their full academic and social potential. If you would like further information please get in touch with us on