OpenHealth Q&A

Could This Be Inflammatory Bowel Disease?

A male child aged 6, standing at 123.5 cm and weighing 30 kg, is a non-smoker and does not regularly encounter smoke exposure. His medical regimen includes a salbutamol inhaler used occasionally, although he has not been formally diagnosed with asthma; he typically requires it during cold weather or when experiencing persistent coughs due to illness. Additionally, he takes antihistamines as needed for a suspected dust allergy. This young boy has experienced persistent health concerns that became more notable last year. In the earlier months, he received a diagnosis of Scarlet Fever, with treatments administered in January, February, and March. It remains uncertain whether these instances were due to a recurrent virus or separate episodes since none of his classmates exhibited similar infections during that timeframe. Throughout this period, he suffered from significant stomach discomfort and nausea that continued even after the viral infection subsided, along with a persistent occurrence of headaches. During this same period, he began to experience frequent falls—a notable concern that was acknowledged by many—and signs of hair loss, night sweats, dark circles under his eyes, in addition to recurrent viral illnesses that appeared more frequently than those of his peers. He has undergone several blood tests, all of which have cleared any alarming conditions in the view of his pediatrician. The results for immunoglobulins fell within the normal range, and the complete blood count also showed normal values. A calprotectin test in November returned a level of 69. Currently, he continues to face issues such as stomach pain, nausea, headaches, and recurring viral infections, albeit at a reduced frequency compared to the previous year. While his falls still occur regularly, they are less frequent than before. The stomach pain he reports is almost daily. Notably, he has had three confirmed episodes of blood in his stool—clearly mixed in without any visible tears, and with soft stool consistency, along with multiple occurrences of mucus. The stool often emits a fishy or chemical odor, a concern raised since he was an infant. He frequently visits the bathroom, experiencing periods of urgency, as well as days where he feels the need to go but does not. There have also been instances of “accidents.” Given the ongoing stomach distress and the presence of blood and mucus in his stool, he underwent both endoscopic and colonoscopic examinations. The results indicated that everything appeared normal at a glance, although attached images have raised questions when referenced with online resources. Additionally, around the same time as his health concerns emerged, he developed anisocoria, where his right eye did not dilate properly. Assessments by both an optometrist and ophthalmologist confirmed the physical health of his eyes, but a review from a neuro-ophthalmologist is still pending. Thank you for any insights you may provide; they are greatly appreciated.

Answers (1)

2/9/2026, 11:40:34 AM

OpenHealth AI

It sounds like you're understandably concerned about your child's ongoing symptoms and the possibility of inflammatory bowel disease (IBD) or other underlying conditions. The key points from your description include persistent stomach pain, blood and mucus in the stool, fatigue signs (like dark circles), and recurring infections. It’s important to consider these symptoms holistically as they can indicate an underlying issue, though we must also remain cautious about jumping to conclusions.

Explanation:

Inflammatory bowel disease, which includes conditions like Crohn's disease and ulcerative colitis, can cause symptoms such as abdominal pain, blood in the stool, and mucus production. However, other conditions could also be involved, especially since he has had a background of infections and potential allergies.

Your child's history of Scarlet Fever and the recurrent episodes raise the question of whether there is an underlying immune issue or chronic inflammation. The calprotectin level you mentioned (69) suggests there might be some intestinal inflammation, even though the biopsies showed normal results, which can sometimes happen in cases of IBD.

Given the ongoing digestive issues and concerning symptoms, here are some prioritized next steps:

Next Steps:

1. Dietary Review: Begin tracking his food intake and symptoms to identify any potential dietary triggers. Consider eliminating common allergens (such as dairy or gluten) for a period to see if symptoms improve. Keeping a food diary can be helpful.

2. Hydration and Nutrition: Ensure he stays well-hydrated and maintains a nutritious diet to support his overall health. Incorporate easy-to-digest foods and avoid overly processed items.

3. Monitor Symptoms: Continue tracking his bowel habits and any symptoms like pain or blood in his stool. Keeping a detailed diary can help healthcare providers to understand patterns and triggers.

4. Follow-Up with Specialists: It’s important to follow up with the neuro-ophthalmologist regarding the anisocoria to rule out any neurological issues. Discuss the ongoing gastrointestinal symptoms with a pediatric gastroenterologist, particularly the symptom of blood in the stool.

5. Investigate Fatigue: Consider a complete metabolic panel if not already done, to check for any deficiencies (like iron or vitamin D) that might be contributing to his fatigue and other symptoms.

6. Routine Check-Ups: Regular follow-ups with the pediatrician to monitor overall health and development, addressing any new or worsening symptoms promptly.

By focusing on understanding and addressing these symptoms while coordinating with specialists, you can work towards finding a clearer diagnosis and management plan that supports your child's health. It's completely normal to feel anxious about this situation, and seeking expert input is a positive step forward. Please continue to share any updates or changes in his condition for more tailored guidance.