Inflammatory Bowel Disease (IBD) Program

Inflammatory bowel disease (IBD) is a chronic condition caused by inflammation in the digestive tract. There are two main types of IBD—ulcerative colitis and Crohn’s disease. Each of these diseases can be disabling. Symptoms can include severe abdominal pain, diarrhea, fatigue, weight loss and growth failure.

Because the symptoms of ulcerative colitis and Crohn’s disease are similar to those of other gastrointestinal conditions, the pediatric gastroenterology experts at CHOC Inflammatory Bowel Disease (IBD) Program use advanced diagnostics and the latest, evidence-based research to diagnose and create personalized treatment plans designed to help children and teens live their lives to the fullest.

About the CHOC Inflammatory Bowel Disease Program

When a child or adolescent is diagnosed with irritable bowel disease, the entire family is affected. IBD may require ongoing medical management throughout the child’s lifetime. At CHOC, we offer pediatric-specific medical treatment of IBD. You will receive a complete, personalized care plan targeting your child’s individual needs. Our goal is to share the best evidence and tools for helping your child achieve remission and get back to being a kid.

CHOC is the only Orange County hospital that participates in the ImproveCareNow (ICN) network, whose purpose it is to transform the health and care for all children and adolescents with IBD.

Our Inflammatory Bowel Disease Program includes:

  • Board-certified pediatric gastroenterologists, many of whom work with the latest advancements in IBD research and are leaders in developing new treatment therapies
    • IBD program coordinator: Rubi Gomez
    • Registered nurses: Katherine Mansfield and Katie Kabana
    • Registered dietitian: Alexis Fissinger
    • Social worker: Krishna Diyarza
    • Psychologist: Dr. Wendy Gray
  • Care coordination and open communication with your child’s primary care provider
  • Comprehensive inpatient and outpatient management for children and teens with IBD
  • Inpatient care includes personalized transition to our outpatient program
  • Multidisciplinary care from multiple subspecialties, including pediatric surgery, nutrition, social services and behavioral health support
  • Infusion services
  • Registered dietitians who specialize in the unique needs of children and teens with IBD
  • IBD Parent Advisory Board
  • Ongoing research into the causes of IBD and development of new treatments for IBD through the CHOC Research Institute.

What is Inflammatory Bowel Disease?

Inflammatory bowel disease involves chronic inflammation of all or part of your digestive tract. IBD primarily includes ulcerative colitis and Crohn’s disease.

Crohn’s Disease

Crohn’s disease is an inflammatory bowel disease with inflammation that may be penetrate through the entire thickness of the intestine and can affect any area of the gastrointestinal tract, from the mouth to the anus. It most commonly affects the small intestine but often affects the colon. Some patients may also get sores or openings around the anus. It is a chronic condition that may come back at various times throughout a person’s lifetime. Crohn’s disease symptoms include abdominal pain, diarrhea, weight loss and growth failure. Learn more about Crohn’s.

Ulcerative Colitis

Ulcerative colitis is an inflammatory bowel disease with inflammation affecting the inner lining of the large intestine (colon), often including the rectum. It is a chronic condition that may require attention throughout a person’s lifetime. Ulcerative colitis symptoms include abdominal pain and diarrhea with blood and mucous in the stool. Learn more about ulcerative colitis.

A Team Approach to Hope and Healing

Treating inflammatory bowel disease in children and teens can be complex and often requires a team of caregivers. At CHOC, we understand the specialized expertise and multidisciplinary approach needed to care for IBD. Our specialists work together as a team to treat your child and may include care from multiple subspecialities, as needed, including gastroenterology, pediatric surgery, nutrition, social services and behavioral health support.

We have a dietitian and psychologist who work exclusively with our gastroenterology patients. They provide our patients with the dietary, emotional and psychosocial support they need to cope with their symptoms and ultimately find relief.

Physician examing toddler

Frequently Asked Questions

Crohn's disease and ulcerative colitis are two types of inflammatory bowel disease (IBD).

Crohn's disease:

  • Crohn's disease can affect any part of a child's intestinal tract
  • Symptoms include diarrhea, bleeding, abdominal pain, tiredness, fever or weight loss
  • Can affect the entire thickness of the intestinal wall
  • Can affect different segments of the intestine, skipping some of the middle

Ulcerative Colitis:

  • Affects the colon, and occasionally the lowest part of the small intestine
  • Symptoms usually include abdominal cramps and diarrhea with bleeding
  • Involves on the innermost lining of the intestinal wall
  • Inflammation does not skip sections of the intestine

No. While the symptoms may appear to be similar, IBD and IBS are very different. IBS can cause pain but there is no inflammation of the intestine and it doesn't lead to serious disease, as with IBD.
Approximately 1.6 million Americans currently have IBD, and approximately 80,000 are children. The Crohn's and Colitis Foundation reports that as many as 70,000 new cases of IBD are diagnosed in the United States each year.
Currently, there is no cure for IBD, but research into better treatments and possible cures is ongoing.
No, there is no evidence that IBD is caused by stress. However, living with a chronic illness can be stressful, and stress can contribute to a flare-up. At CHOC, psychologists are available to provide specialized care for children and teens with IBD.
There is no one single diet or eating plan that will do the trick for everyone with IBD. Dietary recommendations must be individualized, depending on which disease you have and what part of your intestine is affected. Furthermore, these diseases are not static; they change over time, and eating patterns should reflect those changes. The key point is to come up with a plan with your medical provider, and strive for a well-balanced, healthy diet.
If your child is feeling well enough to participate, physical activity is encouraged. In addition to the many other benefits of exercise, it can also help maintain bone density, which can be very helpful for children with IBD. Your child’s doctor will give you more specific advice about good activities for your child.
Typically, children can manage their IBD at home and do not require hospitalization. If symptoms become severe, a brief stay in the hospital may be needed so that we can correct malnutrition and stop diarrhea and the loss of blood, fluids and mineral salts. Your child will be treated with a special diet, feeding through a vein, medications, or, in some cases, surgery
A flare-up is a usually a recurrence of one or more of the symptoms that originally led your child to be diagnosed with IBD, such as diarrhea, rectal bleeding and cramping. Most people with IBD experience an occasional flare-up. If your child seems to be showing symptoms of a flare-up, it’s a good idea to check in with your child’s primary care doctor or gastroenterologist.

IBD and Nutrition

Nutrition is an important part of managing inflammatory bowel disease (IBD). At CHOC, your child will have access to visits with a pediatric IBD dietitian who can provide evidence-based, individualized recommendations to support the growth and wellbeing of your child. Visits can be conducted in our outpatient clinics, over telehealth platforms or in the hospital if your child is admitted.

Food choices and nutrition optimization are important during a flare, around times of surgery and while in remission.
Guidance from a pediatric IBD dietitian can help to:

  • Reduce exacerbation of symptoms
  • Prevent or reverse nutrient deficiencies
  • Optimize growth, strength and development
  • Guide dietary therapy as primary or complementary therapy, when appropriate
  • Preserve or restore a good relationship with food, with assistance from CHOC’s IBD psychologist
  • Support a healthy gut microbiome, which research has shown may reduce risk of disease progression in some.

At CHOC, we treat the entire child, not just the disease. We understand the vital role that food plays in quality of life and community. Our IBD dietitian can provide recipes and personalized guidance to preserve those important aspects of both child and family life.

Visit the Crohn’s & Colitis Foundation for more nutrition information and recipe ideas.

Patient Resource: CHOC'S Guide for Your IBD Road to Wellness

Three boys playing on the ground

Information about Inflammatory Bowel Disease (IBD) is very important and patient education is mainstay of CHOC. We are dedicated to helping every parent and child to fully understand his or her disease and its management. This manual is designed for CHOC IBD patients.

Meet Our Team

Wang, Michael K. DO

Specialty: Gastroenterology
Office: 714-509-4099

Dr. Michael Wang is a board certified pediatric gastroenterologist and co-director of the IBD Program at CHOC.

Appel, Keren L. MD

Specialty: Gastroenterology
Office: 714-509-4099

Dr. Keren Appel is a board certified pediatric gastroenterologist and co-director of the IBD Program at CHOC.

Grant, Kenneth E. MD

Specialty: Gastroenterology
Appointments: 888-770-2462
Office: 714-509-4099

Dr. Kenneth Grant is a board certified pediatric gastroenterologist who treats the full spectrum of gastroenterology disorders of children in Orange County.