Muhammad Anas, now 18, first experienced severe abdominal pain at the age of eight, a condition that disrupted his daily activities and school attendance. After several months of undiagnosed symptoms and ineffectual treatment for presumed gastric issues, Anas was eventually diagnosed with Crohn’s disease, a form of inflammatory bowel disease (IBD), following tests at the Khoo Teck Puat – National University Children’s Medical Institute (KTPNUCMI) and National University Hospital (NUH).

IBD, which involves chronic inflammation of the digestive tract, is becoming increasingly common among children in Singapore. The two primary forms are Crohn’s disease and ulcerative colitis, with Crohn’s disease comprising the majority of paediatric cases in the region.

Experts from KTPNUCMI report a significant rise in new paediatric IBD cases since 2010. Data analyses show that patient numbers nearly doubled between the periods of 2010–2014 and 2015–2019. Children diagnosed often present at a young age, with about 30% diagnosed before age six, 20% between six and 10 years old, and half over 10.

At KK Women’s and Children’s Hospital (KKH), annual new cases ranged from 16 to 20 before 2020 but rose to between 23 and 30 during the COVID-19 pandemic period from 2020 to 2022, before returning to earlier levels post-pandemic. Nonetheless, the overall number of pediatric patients under care for IBD has shown an upward trend since the 2000s, reflecting a global increase in the condition.

Medical professionals note that the rise in paediatric IBD cannot be attributed to a single cause. Contributing factors may include urbanized living environments, dietary patterns high in sugar, fat, and preservatives but low in fiber, exposure to secondhand smoke, and early childhood antibiotic use that may disrupt the gut microbiome. A family history of IBD also increases risk.

Recognition of IBD in children is often challenging due to non-specific symptoms. While Crohn’s disease is commonly associated with abdominal pain and bloody diarrhea, some children may instead experience prolonged fever, poor growth, loss of appetite, or joint inflammation, sometimes preceding intestinal symptoms. This variability can result in delayed diagnosis, which averages about nine months after symptom onset.

Treatment for pediatric Crohn’s disease involves a multidisciplinary approach. Options include exclusive enteral nutrition (EEN), a liquid formula diet used for several weeks to reduce inflammation and promote healing, and biologic therapies that target the abnormal immune response responsible for gut damage. Some patients, like Anas, require steroid infusions and biologic therapy administered intravenously or by injection to maintain disease remission.

Complications of Crohn’s disease may include fistulas—abnormal connections between the bowel and skin—as well as impaired growth and delayed puberty due to persistent inflammation and poor nutrient absorption.

Parents such as Anas’ mother, Anisah Begum, emphasize the importance of early recognition and intervention. She altered the family diet to reduce processed foods and increase vegetables and steamed dishes following her son's diagnosis.

Though there is currently no definitive evidence that lifestyle or dietary changes can prevent IBD, clinicians recommend maintaining a balanced diet rich in fruits and vegetables, minimizing processed foods, ensuring adequate exercise and sleep, and judicious use of antibiotics during early childhood.

The medical community continues to advocate for heightened awareness of pediatric IBD symptoms among parents and healthcare providers to facilitate earlier diagnosis and comprehensive care, aiming for full symptom remission and improved quality of life for affected children.