Q. My child aged 12 years old has bloody stools since past 2 months. He had been treated for diarrhea, dysentery, but to no avail. What to do?
A. The bloody stools which have remained since two months in a 12 year old child is a matter of concern, particularly so because he has clearly been treated for diarrhea and dysentery. In such a situation one should make a determined effort to make the diagnosis.

One of the common conditions that mimic this would be POLYP. Rectal examination will definitely give the diagnosis.

If truly the bloody stools have not subsided inspite of routine treatment, child must be examined (by sigmoidoscopy) to exclude inflammatory bowel disease.

Q.What is Inflammatory Bowel Disease?
A. Inflammatory bowel disease is a chronic condition where there is inflammation of the large and or small intestine without a definite cause, which has a tendency to recur. The commonest finding on sigmoidoscopy is granularity, and tendency to bruise and bleed to touch.

Q. What are the various types of IBD?
A. The various types of IBD are:
Ulcerative colitis (UC)
Cohn's disease (CD)

Q. What are the causes of IBD?
A. The exact cause of IBD is not known. However are the pointers towards these hypothesis. It may be that, there is no single cause, and there may be more than one cause, acting in union.

The causes of IBD are:
A. ULCERATIVE COLITIS
          1. Infection
          2. Food allergy
          3. Environment

B. COHN'S DISEASE
          1. Infections
          2. Diet
          3. Genetics
          4. Psychosocial

Q. When do you suspect a child has IBD?
A. One should suspect a patient to have IBD UC: Child will complain of diarrhea, rectal bleeding, passage of mucus and abdominal pain. Child can also have nausea, anorexia and in severe cases may even vomit. There may also be fever, anemia and weight loss.

Cohn's disease: Child may have pain in right sided pain which is recurrent and colicky in nature. There may also be pain during defecation and pain may increase after defecation. Diarrhea, fever, weight loss, bleeding per rectum may be other manifestations.