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Updated: Aug 17, 2026
Investigating Intestinal Inflammation in DSS-induced Model of IBD
Published on: February 1, 2012
Presenting features of inflammatory bowel disease in Great Britain and Ireland
1Department of Gastroenterology and Nutrition, Bristol Children's Hospital, Bristol, UK.
Insights
Many children with inflammatory bowel disease (IBD) face delayed diagnoses and growth problems. Early recognition of IBD symptoms is crucial for timely intervention and better outcomes in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Clinical Pediatrics
Background:
- Significant delays in diagnosis and impaired growth are reported in pediatric inflammatory bowel disease (IBD) cases.
- Existing data primarily comes from individual referral centers, potentially skewing prevalence and presentation insights.
Purpose of the Study:
- To prospectively document the presenting features of newly diagnosed IBD in children.
- To investigate delays in presentation and disease localization.
- To assess growth patterns in pediatric IBD patients.
Main Methods:
- A prospective survey of 3247 UK and Ireland-based pediatricians, gastroenterologists, and surgeons.
- Monthly reporting of newly diagnosed childhood IBD cases over a 13-month period (June 1998 - June 1999).
- Identification and analysis of 739 new IBD cases in children under 16 years.
Main Results:
- Only 25% of Crohn's disease (CD) cases presented with the classic triad; 50% lacked diarrhea. Median diagnostic delay was 5 months (mean 11 months), with 20% experiencing delays over a year.
- Delays were more frequent in CD and younger children. Short stature was observed exclusively in CD patients, particularly those with jejunal involvement.
- Most CD cases showed ileo-colonic involvement. Ulcerative colitis (UC) predominantly presented as pancolitis, with rare instances of isolated proctitis.
Conclusions:
- Prolonged diagnostic delays and growth failure are common in pediatric IBD.
- Enhanced awareness of IBD's diverse presenting features is needed.
- Earlier investigation of suspected IBD cases could mitigate diagnostic delays and improve patient outcomes.
Background:
Reports from individual referral centres suggest that a significant proportion of children with inflammatory bowel disease (IBD) present after prolonged delays and with impaired growth.
Aims:
To prospectively document the presenting features, delay in presentation, disease localisation, and growth in newly diagnosed cases of IBD.
Methods:
For 13 months, between June 1998 and June 1999, 3247 paediatricians, adult gastroenterologists, and surgeons across the UK and Ireland were prospectively surveyed each month and asked to report every newly diagnosed case of childhood IBD.
Results:
A total of 739 new IBD cases aged less than 16 years were identified. Only one quarter of Crohn's disease (CD) cases presented with the "classic triad" of diarrhoea, weight loss, and abdominal pain; nearly half did not report diarrhoea. The median delay from onset of symptoms to diagnosis was 5 months (mean 11 months), with one fifth having symptoms of more than one year. Delays were most common in CD and in younger children. Short stature was noted only in those with CD and not with ulcerative colitis. One fifth of CD cases had disease activity in the jejunum and this group had significantly reduced stature. Ileo-colonic involvement was documented in most CD cases, with only a small minority having isolated ileal or isolated colonic disease. Pan-colitis was reported in most UC cases, with very few having only an isolated proctitis.
Conclusions:
Many children are diagnosed after prolonged delays and have growth failure. Improved knowledge of the presenting features of IBD, and earlier investigation of suspected cases, may help reduce the delays noted.
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