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Growth failure in the child with inflammatory bowel disease
1Division of GI & Nutrition, Center for Pediatric Inflammatory Bowel Disease, The Children's Hospital of Pennsylvania, The University of Pennsylvania School of Medicine, Philadelphia 19104, USA.
Insights
Chronic inflammatory bowel disease (IBD) is increasingly diagnosed in children, often presenting as growth failure. Early detection and nutritional therapy are crucial for managing IBD
Area of Science:
- Pediatric Gastroenterology
- Pediatric Endocrinology
Background:
- Chronic inflammatory bowel disease (IBD) is increasingly prevalent in pediatric populations.
- IBD diagnosis in children requires vigilance for subtle signs beyond gastrointestinal symptoms.
Observation:
- Growth failure can be the sole presenting sign of IBD in children.
- Delayed puberty and impaired bone mineralization are significant manifestations of pediatric IBD.
- Frequent assessment of growth and development is essential for monitoring disease activity.
Findings:
- IBD significantly impacts linear growth, weight gain, and bone accretion in pediatric patients.
- Delayed sexual development in adolescents with IBD affects self-esteem and final adult height.
- Nutritional therapy is a critical component of IBD management, addressing both undernutrition and disease activity.
Implications:
- Pediatric gastroenterologists must employ specific monitoring and intervention strategies for IBD.
- Early identification and management of IBD in children are vital to optimize long-term growth and development.
- Addressing the unique challenges of IBD in pediatric patients is crucial for comprehensive care.
Abstract:
Once considered rare in pediatric practice, chronic inflammatory bowel disease (IBD) is now being recognized with increasing frequency in children of all ages. In IBD, growth failure may be the only clinical presentation; it is imperative to perform a detailed history and physical examination to search for other systemic and gastrointestinal manifestations of the disease. IBD can have a significant impact on linear growth, weight gain, and bone mineralization, and can cause delays in the onset of puberty. Delays in growth and sexual development can be early indicators of disease activity, and assessment of growth and development should be performed frequently. Nutritional therapy is important not only to correct undernutrition, but also as therapy for IBD. Delayed puberty can have a significant impact on the self-esteem of the adolescent patient and diminish final adult height. Loss of bone mineral density is especially significant during a period in which the majority of bone accretion is expected to occur. These issues present unique problems to the gastroenterologist caring for a child or adolescent with IBD and require specific types of monitoring and interventions.