Jacob takes medication at least twice every day. When his condition flares, he takes stronger, steroidal drugs. He suffers from headaches, possibly as a side effect of medication or simply from the sleep deprivation that comes with having to go to the bathroom all night long. Long-term steroid use can stunt growth and cause other problems. But so can leaving the colitis unchecked. Decreased bone density is common in young patients because it affects the absorption of vitamin D and other nutrients, according to the foundation.

"For pediatrics, growth is probably the No. 1 [problem]," Yeung said. "One reason is, if it's not under control, there's malabsorption of nutrients. And you're not very hungry because your tummy hurts."

It is nevertheless possible to lead a full life with inflammatory bowel disease.

"I have students with this disease that are national volleyball players, football players," Yeung said. "But it's still hard. It's one thing if you have asthma and you can't breathe. It's another thing if you have diarrhea."

Jacob had to give up track and baseball because there were not always bathroom facilities available at meets and games. But he has continued to play Amateur Athletic Union basketball.

"He's in the hospital one day, and two days later plays in tournament," said his father, Dave Krause, 36. "He's been very strong."

Some of the testing done to diagnose colitis can feel as awful as the disease itself. Having trouble getting Jacob to take a barium drink last year, his parents turned it into a game. They had Jacob shoot hoops at the end of his cul-de-sac as he drank. If he made a shot, he'd take a sip. If he missed, he'd have to chug.

While he shot and mostly chugged —Jacob claims to "own the free throw line," but the drink and the day's fasting took their toll on his aim — he wished aloud that he could do something so other kids wouldn't have to undergo such an awful test. He and his parents came up with the idea of having a free-throw tournament to raise money for research. Ten weeks later, they put on the tournament and raised $35,000 for the Crohn's and Colitis Foundation and Johns Hopkins Children's Center.

His second fundraising tournament takes place Sunday afternoon at Meadowbrook Athletic Complex in Ellicott City.

The event goes on this year despite a new medical challenge for the family. Jacob's mother, Jill Krause, 38, was diagnosed with breast cancer last spring. She had a double mastectomy in June and is undergoing chemotherapy.

"We've got a lot going on," the mother of four said wryly.

"With what's been going on with me, he's been an amazing source of strength," she said. "I had to do barium."

Jacob broke in: "It was the worst thing ever!"

"He got me through barium," Jill Krause continued. "Not that I'd ever want to have this medical bonding with my child. ... You've got to be positive. Positive takes you a long way."

laura.vozzella@baltsun.com

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