Class Management, Mental Health & Well-being

Bathrooms and Blackboards: Helping Students with IBD

Bathrooms and Blackboards: Helping Students with IBD

Originally published August 2016

By Sandra DiFelice

School is a part of every child’s life. During their academic years, students deal with so many different facets of growth and development—physical, cognitive, emotional, and social. Having a chronic illness on top of the regular day-to-day stressors of being a student can be an enormous burden and challenge.

Here’s a startling truth: Canada has one of the highest rates of inflammatory bowel disease (IBD) in the world. Approximately one in 150 Canadians lives with IBD, an umbrella term for Crohn’s disease and ulcerative colitis. Unfortunately, rates of IBD have been rising, particularly amongst children under the age of 10, meaning students with these unpredictable, painful, and potentially embarrassing diseases are increasingly present in our classrooms.

IBD occurs when the immune system mistakenly attacks all, or part, of the digestive tract, causing inflammation. Students with IBD may suffer from frequent (and sometimes bloody) diarrhea, abdominal pain and cramping, nausea, vomiting, decreased appetite, weight loss, anemia, malnutrition, fatigue, poor growth, pubertal delays, joint pain/stiffness, and skin afflictions. Students living with IBD frequently experience the urgent, unexpected need to use the bathroom and, consequently, are fearful of having an accident at school.

With the growing number of early-onset cases of IBD, educators need to be aware that students in our classrooms may have this disease. It is important to help educators learn about IBD and understand how they can help minimize any negative impact this disease can have on a student’s academic performance and school experience.

Students with IBD need additional support at school

Last year, I had the privilege of working with the Canadian Digestive Health Foundation and Robbie’s Rainbow to develop a free resource to help educators better understand the impact IBD symptoms and treatments can have on their students. The resource, Blackboards and Bathrooms, provides educators with practical strategies and tools they can easily incorporate in the classroom. With this resource, educators will better understand:

  • The impact that fluctuating and unpredictable IBD symptoms and treatments can have on a student’s health, behaviour, and academic performance;
  • How to help minimize the impact the disease has on a student’s academic performance;
  • How to support frequent absences, lateness and engagement at school;
  • How to observe the signs of social distress, pain, or physical side effects due to treatment they may be experiencing;
  • How specific accommodations may allow students with IBD have a more positive school experience.

The impact of IBD in the classroom


Inflammatory bowel disease is chronic, inconsistent, and stressful. Symptoms can vary dramatically from wellness one week to illness the next. Students with IBD may have flares (when symptoms get worse) that occur unexpectedly, as well as, alternating periods of remission. Students may not appear ill even when the disease is active. Medications for IBD can have side effects that impair concentration and can affect mental functioning and mood in highly variable ways.

While every day is unpredictable for students with IBD, there are some common issues they all face. IBD symptoms, clinic appointments, tests, and hospitalization may interfere with punctuality, attendance, and engagement at school. If students don’t have the opportunity to catch up, they may become frustrated and lose interest during learning activities, and risk falling behind. All of these factors may also lead to day-to-day fluctuations in energy, concentration, participation, and achievement. Students suffering from this disease may be unable to participate fully in activities requiring strength or stamina, such as physical education or extracurricular sports.

Looking at IBD from a student’s perspective

Many students with IBD have told me that their need to use the toilet frequently and without warning and this causes them the most anxiety and stress at school. IBD can result in intense cramps that can come on suddenly, creating the need to immediately access a bathroom. This urgency may be so intense that it can result in an accident if there is a delay in reaching the toilet.

This particular stressor is why Blackboards and Bathrooms includes a printable All-Access Bathroom Pass, so students with IBD can hand one to any staff member who may not understand their condition symptoms access to the bathroom with no questions asked.

I encourage educators to spend time reading Blackboards and Bathrooms, and sharing this important resource with their colleagues. With the help of an understanding and supportive school culture, together with strong parental support and medical care, it is my hope that all students with this disease will be able to thrive in the classroom and realize their full academic potential.

Sandra DiFelice is a Vice Principal in the Halton District School Board.