Inflammatory bowel disease (IBD) is a condition that causes inflammation in the bowel, and refers to Crohn disease and ulcerative colitis. For information on the symptoms and treatment for IBD, see our fact sheet
Inflammatory bowel disease (IBD).
Students with IBD often have special problems and require extra support, care and attention at school. The information in this fact sheet is designed to help teachers understand the problems faced by these students at school.
Medications (e.g. cortisone) are used to help relieve symptoms. In some young people, IBD is mild and easily controlled; in others, control may be more difficult. In a minority of young people, surgery may be required to deal with severe disease or complications.
IBD is not contagious and there is no risk to other students or staff.
The impact of IBD on the student
The effect of the illness on the student may be considerable, and they may be particularly embarrassed by a problem with the bowels.
The cortisone medication the student has to take can cause side effects that are distressing, such as weight gain, an increase in pimples, mood swings, difficulties concentrating and headaches. The real and imagined impact on body image can be especially upsetting.
In addition, loss of school time, falling academic performance and missing out on activities and sport may cause more frustration and difficulties.
The most difficult problem that students may have to deal with at school is the need to go to the toilet urgently and with little warning. The fear of this happening and being unable to get to the toilet in time may be a cause of considerable anxiety and can lead to school refusal.
How schools can support students with IBD
The support and encouragement of teachers and the school community is vital to enable the students to develop to their full academic and social potential.
Arrangements should be made to enable the student to leave class quickly and with a minimum of fuss. To be questioned in front of classmates is embarrassing, and even a short delay may result in an accident. A system of codes or signals known to all involved teachers may be used, or the
student should be given the freedom to leave class at any time if necessary.
Most young people will respond maturely and not abuse the privilege. Special use of staff toilet facilities may be possible especially if the student facilities are a long way from the classroom. Above all, the students should feel confident that their special circumstances can be handled
with discretion and understanding.
Because these are chronic or recurring illnesses, there will inevitably be times when the student is away from school, or affected by symptoms or side effects of the treatment while at school. These symptoms can interfere with the student's concentration or performance in class work,
homework, examinations, sport, excursions and other activities.
Excursions, camps and sport
Most affected students will be able to fully participate in school and social activities, but they may need understanding and special consideration from teachers and peers in some circumstances.
Ideally, the student will be well enough to fully participate in all activities. At other times, fear of pain, diarrhoea or a lack of available toilets may be distressing. As a result, the student may want to opt out of an activity. Simple measures such as arranging an aisle seat in the
theatre, auditorium or on the bus should be considered.
Sporting activities may be affected by abdominal pain, joint problems and general poor health but students should be encouraged to take part within their current limits. Some will push themselves too hard so they don't appear to be quitting in the eyes of their peers, and they may need to be encouraged to pace
themselves.
Teachers and supervisors need to understand that there will be better and worse days and to give the students the benefit of the doubt if they decide they are unable to participate on a particular day. There may be times when specific restrictions are imposed, for example after surgery. Individual programs may
need to be worked out to enable the student to participate to their fullest.
Absenteeism and hospitalisation
There may be loss of attendance at school due to illness, hospitalisation (which can last from a few days to a few weeks) or visits to the doctor, as well as time at school spent in the sick bay or the toilet.
School work and assignments can be sent home or to the hospital. Visits and cards from classmates and teachers are appreciated to keep in touch both academically and socially.
What to look out for at school
For the most part, students with IBD will be well and can be treated normally. It is unlikely that any emergencies will occur at school or that the teachers will be called on to provide any treatment or first aid. However, students, parents and teachers should have a clear plan of action if
problems do arise at school.
Teachers should be aware that although students may appear to be well, they may have significant and fluctuating symptoms. Watch out for signs of tiredness and unhappiness and be prepared to discuss concerns with the parents if necessary.
Communication
Teachers should discuss potential problems and plans of action with students and their families. Although emergencies or severe symptoms are unlikely to arise at school, there should be clear lines of communication. It may be helpful for teachers and counsellors to talk to the
doctor (usually a paediatric gastroenterologist) and other health professionals involved in the young person’s care.
Whether or not the class is told about the student's condition is something that should be discussed with the student and family. Peers and other teachers should have at least a degree of understanding about the nature of the problem to minimise feelings of isolation and risks of
teasing. Possible ways to involve the class include a show and tell session for younger children, or a science or health project for older students.
Key points to remember
- The effect of the illness and the side effects of medication on the student may be considerable.
- Arrangements should be made to enable the student to leave class quickly and with a minimum of fuss.
- Students with IBD are usually well, and can often fully participate in school, sport and social activities. Special arrangements may need to be made.
- Students may be absent for short periods of time, or may need to spend a few days or weeks in hospital.
- There should be a plan of action if students become unwell at school.
For more information
Developed by The Royal Children's Hospital Gastroenterology and Dietetics departments. We acknowledge the input of RCH consumers and carers.
Reviewed July 2018.
This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.
Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit
www.rchfoundation.org.au.