Healthcare
USA
When to seek medical help for your child’s IBD
Learn how to recognise worsening IBD symptoms in your child, when to contact their healthcare team, and when to seek urgent or emergency medical care in the USA.
When your child has Crohn’s disease or ulcerative colitis, it can sometimes be difficult to know whether a new symptom is part of their usual condition or a sign that they need medical attention.
Inflammatory bowel disease (IBD) can change over time, and symptoms may worsen even when your child is taking medication. Knowing which warning signs to look for, who to contact, and when to seek emergency care can help you respond quickly and confidently.
In the USA, your child’s pediatric gastroenterology team should provide guidance on managing symptoms between appointments and explain when urgent medical assessment is needed.
🟡 When should you contact your child’s IBD team?
Contact your child’s gastroenterologist or IBD nurse if you notice new symptoms, a change in their usual pattern, or signs that their condition may be worsening.
These may include:
More frequent diarrhoea or bowel movements than usual.
Blood or increased mucus in the stool.
New or persistent abdominal pain.
Increased urgency or difficulty reaching the toilet.
Reduced appetite or unexplained weight loss.
Unusual tiredness, weakness, or reduced energy.
Fever or symptoms that could indicate an infection.
Symptoms that return after a period of feeling well.
You should also contact the team if your child experiences possible medication side effects, struggles to take their medication, or has missed important doses.
Do not assume that every symptom is caused by IBD. Infections and other conditions can produce similar symptoms, so your child may need further assessment or testing.
🟠 What symptoms need urgent medical assessment?
Some symptoms require prompt medical assessment, even if your child has experienced flares before.
Seek urgent medical advice if your child has:
Increasing or persistent abdominal pain.
Significant or increasing blood in the stool.
Repeated vomiting or difficulty keeping fluids down.
Signs of dehydration, such as reduced urination, a very dry mouth, or dizziness.
A persistent fever, particularly if your child takes medication that suppresses the immune system.
Marked weakness, worsening fatigue, or a sudden deterioration in their general condition.
Contact your child’s medical team promptly for advice about where they should be assessed. If you cannot reach the team and your child’s symptoms are worsening, seek urgent care.
🔴 When should you go to the emergency department?
Some symptoms may indicate a serious complication and should not wait for a routine appointment.
Seek emergency medical care if your child has:
Severe or rapidly worsening abdominal pain.
A swollen or distended abdomen with significant pain.
Heavy rectal bleeding or bleeding accompanied by faintness or weakness.
Persistent vomiting with severe pain or an inability to keep fluids down.
Fainting, confusion, difficulty waking, or signs of severe dehydration.
Difficulty breathing or another sign of a severe allergic reaction.
Call 911 in the USA if your child appears seriously unwell or needs emergency assistance.
Do not delay emergency care while waiting for a response from their gastroenterologist.
🌡️ What if your child develops a fever?
Fever can occur with infections and other illnesses, but it is particularly important to take it seriously if your child is receiving immunosuppressive treatment.
Medications such as azathioprine and some biologic therapies can affect the immune system and may increase the risk of certain infections.
If your child develops a fever:
Contact their healthcare team for advice, particularly if they take immunosuppressive medication.
Tell the clinician which medications your child takes and when the last doses were given.
Watch for additional symptoms, including chills, worsening abdominal pain, vomiting, or unusual drowsiness.
Seek emergency care if your child appears seriously unwell.
Follow any fever-management instructions provided by your child’s specialist, as recommendations may differ depending on their medication and medical history.
💊 What if you think your child is having a flare?
A flare occurs when IBD becomes more active, causing symptoms such as diarrhoea, abdominal pain, bleeding, or fatigue.
If you suspect a flare, contact your child’s IBD team. They may recommend blood tests, stool tests, or other investigations to assess inflammation and rule out infection.
While waiting for advice:
Encourage your child to drink fluids if they can tolerate them.
Keep a record of bowel movements, pain, bleeding, and other symptoms.
Continue prescribed medication according to the treatment plan unless the medical team advises otherwise.
Avoid starting new medicines, including anti-diarrhoeal medicines or anti-inflammatory painkillers, without checking with a healthcare professional.
Do not wait for symptoms to become severe before contacting the team. Early assessment can help identify what is happening and whether treatment needs to change.
📞 Who should you contact?
Knowing who to call before a problem occurs can make a stressful situation easier to manage.
Your child’s pediatric gastroenterologist or IBD nurse
Contact the specialist team about worsening IBD symptoms, possible flares, medication concerns, and questions about your child’s treatment plan.
Your child’s pediatrician or primary care provider
They can assess general health concerns and help coordinate care with the gastroenterology team.
Urgent care
An urgent care centre may be suitable for certain non-life-threatening problems, depending on the symptoms and the facility’s capabilities. However, many centres cannot provide the specialist assessment or paediatric investigations needed for a significant IBD complication.
Emergency department
Go to an emergency department for severe symptoms, significant bleeding, suspected serious complications, or when your child appears seriously unwell.
Call 911 for a medical emergency.
📋 How can you prepare for an unexpected flare?
Having a plan in place can help you act quickly if your child becomes unwell.
Keep the following information accessible:
Your child’s gastroenterologist and IBD clinic contact details.
A current list of medications and doses.
Known allergies and relevant medical history.
Your child’s usual symptoms and any recent changes.
Instructions for managing a suspected flare.
Details of your health insurance and preferred hospital, if applicable.
Ask your child’s specialist to provide a written plan explaining which symptoms can be monitored at home, when to call the clinic, and when to seek urgent or emergency care.
If your child is at school, make sure the appropriate staff know whom to contact if symptoms worsen and what steps to take in an emergency.
❤️ Trust your instincts as a parent
You know your child’s usual behaviour and symptoms better than anyone. If they seem unusually unwell, their symptoms are different from previous flares, or you are worried about a sudden change, seek medical advice.
You do not need to wait for visible blood or severe pain before contacting the healthcare team. Children with IBD may need assessment for symptoms that are not obviously related to their digestive condition.
Knowing when to seek help can make a real difference. Keep your child’s medical team involved, follow their personalised advice, and seek emergency care whenever symptoms suggest a serious problem.
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