Self-Image Tops the List of Concerns for Tweens with Crohn's

They're between the ages of 10 and 12 - too old to still be children yet too young to be teenagers.

In some respects, tweens have it much harder than patients in any other age group who suffer from Crohn's disease. Those who have the symptoms of inflammatory bowel disease (IBD) but no actual diagnosis have the toughest situation of all. They suffer and don't know why or how to cope with the unknown culprit.

All who enter their tweens find themselves at an awkward point in time. They're too old for most toys and too young to look more like an adult than a child. They're stuck for a couple of years in physical limbo.

Being a tween has special challenges for individuals with Crohn's disease. Most of them fall into these categories:

Body image: The kidlet is going to be concerned with body image 24 hours a day. Kids on the shy side find it difficult to talk about almost anything pertaining to personal body functions. Their symptoms might tell them something's wrong, but they feel they have nobody with whom to discuss what's happening to them. If the tween has already been diagnosed with IBD and takes steroids, the drugs can delay growth and development so that the patient looks considerably younger than his or her friends. Major surgery and procedures such as ostomies can cause acute self-consciousness.

Groupies: Most pre-teens are at least poised to enter the groupie phase. This means they'll soon start hanging out in packs, communicating 24/7 via text messages. It signifies endless trips in groups to malls or sports events. They generally sit together on the school bus and make whispering an art. Overall, their activities require a pretty high energy level. This is tough for any kid with Crohn's disease. They fear that getting sick means losing their spot in the group because they can't keep up with the others.

School issues: The symptoms of Crohn's disease wax and wane. Most patients will have at least one surgery at some point. Whether the condition ever actually goes into remission is still hotly debated. Kids who have Crohn's can be expected to miss more school than average. For some, keeping up with the academic work can become a problem and might require a paid tutor or going to summer school while friends hit the mall. Because Crohn's is an invisible disability, sometimes adults in authority don't recognize kids as sick and suggest - verbally or by actions - that they're a bit lazy. Kids this age are acutely embarrassed to have an accident if they can't reach the restroom in time and very self-conscious about having to be excused from class. They don't want anyone else to find out they take pills and are acutely ill at east when they have to avoid eating the same type of lunch as their friends are having.

Hormones: They're just starting to rage. The first bumps of acne have arrived, as has the first bra. Orthodontists are part of the picture. Some kids will already have had a few body parts pierced. The logic in what causes other body parts to flutter at the sight of a cute classmate is anybody's guess. Kids this age who suffer from any major medical condition are terrified that the object of their current crush will find out they're sick a lot and dump them. If their parents permit it, older tweens might already be posting on various social sites online. Chances are, you won't find any mention of Crohn's disease in what they write.

Responsibility: As adults, we expect our tweens with Crohn's to know what the disease is and to understand why they get sick periodically. Because they're often tired and sometimes quieter than their healthier friends, we tend to perceive them as older than they really are. We sometimes expect them to take on a level of responsibility for managing their disease with which even some adults have difficulty. A tween cannot be expected to know how to spell all his or her medications, let alone rattle off exactly how each one works. Face it, they miss doses from time to time.

Overall, the best approach any parent of a tween with Crohn's disease or suspected IBD can take is to let the kid be a kid. This means not babying him or her just because of a disability. You can help your son or daughter cope with having Crohn's by repeatedly reinforcing that having the disease is just one aspect of his or her life. Having black hair, loving the color red and being left-handed are others. Help your tween to realize being a whiz at math or playing the cello is just as defining as having a chronic illness.

You should also avoid forcing adulthood on your son or daughter too soon. It will arrive, with all its responsibilities, all by itself and all too soon.