It’s essential to understand…that the conscience doesn’t act independently. It can only act upon a belief system. It is not a belief system. The conscience is not the law of God. It is not the voice of God. It is not moral law. It is simply a mechanism.
John MacArthur

Crohns Disease And Ulcerative

Crohns Disease And Ulcerative

The following article is reprinted with permission from the National Foundation for Ileitis & Colitis, Inc. While this article was written specifically for the teachers of students with Crohn’s Disease and Ulcerative Colitis, the information will be helpful to families and friends of persons with one of these disorders. Many ideas are applicable to other health problems as well.

For more information, please contact:

National Foundation for Ileitis & Colitis, Inc. 444 Park Avenue South New York, NY 10016 (212) 685-3440

A TEACHER’S GUIDE TO CROHN’S DISEASE & ULCERATIVE COLITIS

Some Facts You Should Know:

  1. Crohn’s disease and ulcerative colitis are lifelong illnesses. Medications often alleviate inflammation and discomfort, but do not cure the diseases.
  2. 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.
  3. Crohn’s disease and ulcerative colitis are NOT contagious. Researchers feel the diseases may be caused by an unknown bacterium or virus, or by a defect in the body’s immune system.
  4. 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.
  5. Young people with Crohn’s disease and ulcerative colitis need ready access to a bathroom. Diarrhea is often a severe problem for these youngsters, and getting to a 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.

It would be wonderful if all young people could enjoy good health and smooth adjustment during their elementary and high school years. Unfortunately, some children are plagued with chronic illnesses such as Crohn’s disease and ulcerative colitis. Just getting through the school day can be an extremely difficult task without the support and encouragement of teachers who understand their illness.

ABOUT THE DISEASES

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. Boys and girls appear to be affected equally. These diseases are NOT to be confused with “spastic colon,” or irritable bowel syndrome, a far less serious, unrelated condition.

COPING WITH THE DISEASE AND ITS TREATMENT

“The hardest thing for me to cope with was the fact that I 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. Because many of these children eat less than their bodies require, they often grow at a slower rate and may appear younger and smaller than their classmates. These combined problems often cause them to withdraw and become depressed or angry, especially during the pre-adolescent or adolescent years.

Treatment can cause problems, too. Cortisone-like drugs are effective in controlling, but not curing, the inflammation caused by Crohn’s disease and ulcerative colitis. But these drugs often cause youngsters to gain weight, to develop a rounded puffy appearance, to have worsening of acne, and to become moody and restless. This change in appearance further isolates them from their classmates, who may not be aware of their illness and may ridicule or make fun of them.

ABSENCE FROM SCHOOL

“My biggest problem is that most of my teachers don’t think I look sick!”

Not all young people with Crohn’s disease or ulcerative colitis are small or have side effects of medication. They 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 sleeplessness, making it difficult for the child 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 these illnesses 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 Crohn’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 adults, young persons 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; in many schools, the stalls in the bathrooms do not have doors. 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 solutions acknowledge the reality of the problem and show respect for the student’s feelings.

CLASS TRIPS

“I was never sure what to do about field 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 the student with Crohn’s disease or ulcerative colitis. Attacks of pain, gas, or diarrhea during long bus trips, for example, can cause intense anxiety even in the most secure student. 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.

TAKING MEDICATION DURING SCHOOL HOURS

Students with these conditions often need to take medications during the school day to help control their diarrhea or pain. Schools generally require that these medications be dispensed by the school nurse. This often means that the student must take time from a lunch period or may be late to class as a result. Ongoing communication between the school nurse and the teachers will make this routine easier for the student.

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, a modified gym program may be the answer. Teachers or guidance personnel can usually work closely with parents and the child’s physician in developing an individualized program. If the student has had recent surgery, his or her surgeon will make the determination when it is safe to resume activity.

(For more information on these two disorders, choose “Crohn” and “Ulcerative Colitis” as your search terms in the Rare Disease Database.)