Crohn's disease causes inflammation in the lining of the digestive tract, leading to intestinal cramps and frequent diarrhea. In more severe cases, the damage can spread to deeper layers of the intestines with debilitating effects. Recently experts recognized that the age at diagnosis can help predict the course of the disease.
Diagnosis
The Mayo Clinic stresses that Crohn's disease can strike people of any age. However, they define age as a risk factor and state that most people with Crohn's disease receive their diagnosis between the ages of 20 to 30.
Age Groups
A team of medical experts devised a classification scheme called the Vienna system for patients with Crohn's disease. The system groups patients with similar characteristics to clarify the analysis of symptoms and their response to treatments. In 2005 the experts instituted the Montreal modifications of the Vienna system because of data suggesting that the age at diagnosis predicts the course of Crohn's disease. In the Montreal modification, the experts split the under 40 age group to define a pediatric population of patients age 16 and under and another group aged 17 to 40, while retaining the age group of patients older than 40.
Children
The National Institute of Diabetes and Digestive and Kidney Diseases, or NIDDK, says that most children born to women with Crohn's disease do not inherit the disease. However, those children who do have the disease from birth sometimes suffer from more severe consequences, including slow growth and late puberty. Doctors might recommend high-calorie nutritional supplements for these children.
Children might have a different set of symptoms than older patients with Crohn's disease. The Merck Manual says that children often lack gastrointestinal symptoms like diarrhea or stomach pain, while showing arthritis, anemia and slow growth.
Statistics
In his June 2007 paper in "Canadian Journal of Gastroenterology," Dr. Hugh Freeman presents data on the incidence of patients with Crohn's disease by age at diagnosis. In his group of just over 1,000 patients, over 70 percent received their diagnosis between the ages of 17 and 40, and just over 16 percent were diagnosed after the age of 40. The pediatric group was the smallest with about 11 percent of patients diagnosed at the age of 16 or younger.
Disease Location
Dr. Freeman's analysis showed that the location of the disease within the intestines varies according to age at diagnosis. Patients who are older at diagnosis are less likely to have disease outside of the large intestine (colon). Younger patients are more likely to have disease in the colon and ileum, the lowest section of the small intestine.
Disease Severity
Dr. Freeman's analysis also showed that younger patients, under the age of 40, tend to have more complex disease with a greater risk of complications. Patients older than 40 at diagnosis are more likely to have simple inflammation of the digestive tract, while patients with an earlier diagnosis are more likely to experience narrowing of the intestines or ulcers that eat into the walls of the intestines.
