Understanding puberty when you have Crohn’s disease or ulcerative colitis

Puberty is a time when your body starts changing from a child's body towards an adult body. You might grow taller, notice changes in your body shape, develop body hair, or experience new feelings and emotions.

Everyone goes through puberty at their own pace. But if you have Crohn’s disease or ulcerative colitis (IBD), some of these changes might happen a little later than they do for your friends.

If you've ever wondered why your body seems to be changing differently, you're not alone. Let's look at what puberty means when you have IBD and what you can do to look after yourself.

🌱 What happens during puberty?

Puberty is a normal part of growing up. Your body produces hormones that help you develop and mature.

During puberty, you might notice changes such as:

• Growing taller and gaining weight.

• Your body shape changing.

• Hair growing under your arms and around your private parts.

• Your skin becoming oilier or developing spots.

• Feeling different emotions or experiencing mood changes.

• Your voice getting deeper, if you have a voice that deepens during puberty.

• Your breasts developing and your periods starting, if you have periods.

• Your penis and testicles growing, if you have them.

These changes don't all happen at once. Some people start puberty earlier, while others start later. Both can be completely normal.

🦋 Can IBD affect puberty?

Yes, IBD can sometimes affect when puberty starts and how quickly your body develops.

When your bowel is inflamed, your body needs extra energy to manage that inflammation. You might also have trouble absorbing nutrients, lose your appetite or struggle to eat enough when you're feeling unwell.

This can make it harder for your body to get everything it needs for growth and development.

Some IBD medications, particularly steroids such as prednisolone, can also affect growth when used for long periods or in repeated courses.

As a result, some kids and teens with IBD go through puberty later than their friends.

This doesn't mean you'll always be behind. When your IBD is well controlled and your body gets the nutrition it needs, growth and puberty may catch up.

📏 Why is everyone developing before me?

It can be hard when your friends suddenly seem taller, look older or start talking about changes you haven't experienced yet.

You might wonder if something is wrong with you or feel embarrassed about looking younger than other people your age.

Remember that everyone has their own timeline. Some people start puberty early, while others develop later. Having IBD can sometimes affect this timing, but it doesn't mean your body is broken or that you've done anything wrong.

If you're worried that you're not developing as expected, your IBD team can check your growth and help you understand what's happening.

💙 What if I feel embarrassed about my changing body?

Puberty can bring lots of feelings, even without IBD. When your body changes differently from your friends' bodies, it can feel even more complicated.

You might feel uncomfortable getting changed for sport, worry about what people think or feel frustrated when your clothes fit differently.

Here are some things that might help:

• Be patient with yourself. Your body is developing in its own time.

• Wear clothes that make you comfortable. You don't have to dress like everyone else.

• Talk to someone you trust. A parent, carer, school counsellor or IBD nurse can help if you're feeling worried.

• Remember that bodies are different. There isn't one correct way to look during puberty.

• Take a break from comparisons. Everyone's body develops differently, even if it doesn't always look that way.

You don't have to feel confident about every change. It's okay to have questions, feel awkward or need some time to adjust.

🥗 How can I support my body during puberty?

Your body needs extra energy and nutrients while you're growing. Looking after yourself can help support healthy development and make it easier to manage your IBD.

Try to:

• Eat regular meals and snacks to give your body enough energy.

• Include a variety of foods that you tolerate well.

• Take your IBD medication as prescribed.

• Tell your healthcare team if symptoms make it difficult to eat.

• Attend your check-ups so your team can monitor your growth and development.

• Get enough sleep and rest when you need it.

If you're struggling to eat enough or your growth has slowed, your healthcare team might recommend seeing a dietitian or checking whether you need extra nutritional support.

You don't need to follow a perfect diet. The goal is to give your body the support it needs.

🩺 How can my IBD team help?

Your IBD team can monitor your height, weight and development as you grow. They may ask questions about puberty, check blood tests and look at your growth over time.

If they notice that puberty is happening later than expected, they can investigate possible reasons and discuss what support might help.

Sometimes, they may recommend seeing a specialist who focuses on hormones, growth and puberty.

It's important to tell your team if you're worried, even if you feel embarrassed asking questions. They are used to talking about these changes and want to help you feel comfortable and healthy.

💬 What questions can I ask my doctor?

You can ask anything you're curious or worried about. For example:

• "Could my IBD be affecting my puberty?"

• "Is my growth happening at the right pace?"

• "Will I catch up with my friends?"

• "Could my medication be affecting my development?"

• "Is there anything I can do to help my body grow?"

If you'd prefer to talk without your parent or carer in the room, you can ask your healthcare team whether you can have some time to speak privately.

There are no silly questions when it comes to understanding your body.

⭐ Remember

Puberty can feel confusing, especially when you're also managing Crohn's disease or ulcerative colitis. Your body might develop at a different pace from your friends, but that doesn't mean you've done anything wrong.

With the right treatment, nutrition and support, your healthcare team can help you look after your growth and development.

Your body has its own timeline. You deserve to feel supported, respected and comfortable with who you are at every stage of growing up.