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[Follow-up of pediatric inflammatory bowel disease]
De-xiu Guan1, Xiao-hong Qiu, Zhao-lu Ding
1Department of Gastroenterology, Capital Medical University, Beijing, China.
Insights
This study followed pediatric inflammatory bowel disease (IBD) patients, finding most have a chronic persistent or relapsing type. Crohn's disease (CD) patients had a higher surgical rate and complications compared to ulcerative colitis (UC).
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease (IBD) Research
- Clinical Follow-up Studies
Context:
- Pediatric inflammatory bowel disease (IBD) requires long-term monitoring for effective management.
- Understanding the clinical trajectory of pediatric IBD is crucial for improving patient outcomes.
- This study re-evaluated IBD patients using updated diagnostic criteria for enhanced accuracy.
Purpose:
- To analyze the clinical characteristics and long-term prognosis of pediatric inflammatory bowel disease (IBD).
- To improve the diagnosis and management strategies for IBD in children.
- To compare the outcomes and characteristics of ulcerative colitis (UC) and Crohn's disease (CD) in pediatric patients.
Summary:
- A cohort of 56 pediatric IBD patients (34 UC, 22 CD) were followed up. Most patients exhibited a chronic persistent or relapsing disease course.
- Crohn's disease (CD) showed a significantly higher surgical rate (36.4%) and more frequent surgical complications (e.g., intestinal obstruction, perforation) compared to ulcerative colitis (UC) (8.8%).
- Despite disease activity, the majority of pediatric IBD patients maintained unrestricted physical activities, with 55.2% (UC) and 68.2% (CD) remaining symptom-free.
Impact:
- Provides valuable insights into the long-term clinical course and prognosis of pediatric IBD.
- Highlights the differential surgical management needs and complication risks between pediatric UC and CD.
- Informs clinical practice for better diagnosis, treatment, and patient support in pediatric IBD.
Objective:
To analyze the clinical characteristics and prognosis of pediatric inflammatory bowel disease (IBD) through a long-term follow-up so as to improve the diagnosis and management of IBD in children.
Methods:
Seventy-three IBD patients admitted into our hospital from May 2000 to September 2010 were re-evaluated with the uniform diagnostic criteria proposed by the 2010 consensus diagnostic criteria for pediatric IBD. All patients were followed up by questionnaire, telephone and face-to-face interview.
Results:
Among them, 56 cases (76.7%) (ulcerative colitis (UC): n = 34, Crohn's disease (CD): n = 22) were available for follow-up study. Among 34 UC cases, 13 cases had their diagnosis confirmed and 21 cases were diagnosed as probable UC. Meanwhile, among 22 CD cases, 14 and 8 had definite and probable diagnoses respectively. At diagnosis, 46.9% (15/32) of UC patients had extensive colitis, 40.6% (13/32) left-sided colitis while 72.7% (16/22) of CD patients with had ileocolonic. And 28 cases (82.4%) of UC patients and 20 cases (90.9%) of CD patients fulfilled the criteria for moderate to severe grade. Among 56 IBD cases, there was no death for CD, but 5 died for UC (14.7%). In the remaining 29 UC and 22 CD patients, 16 cases (55.2%) and 15 cases (68.2%) stayed symptom-free (P > 0.05). Moreover, 8 cases (27.6%) of UC and 3 cases (13.6%) of CD patients belonged to chronic relapsing type while 16 cases (55.2%) of UC and 15 cases (68.2%) of CD patients were of chronic persistent type. The physical activities of most IBD patients (n = 49) were unrestricted. The surgical rate for IBD was 19.6% (n = 11), 8.8% for UC (n = 3) and 36.4% for CD (n = 8) (P < 0.05). The incidences of surgical complications such as intestinal obstruction, intestinal perforation and hemorrhage of gastrointestinal tract were 7.1% (n = 4), 7.1% (n = 4) and 1.8% (n = 1). And it was more common in the CD group.
Conclusions:
Most IBD patients belong to chronic persistent type and then chronic relapsing type. Their physical activities are unrestricted. The surgical rate for CD is significantly higher than UC. And surgical complications such as intestinal obstruction, intestinal perforation and hemorrhage of gastrointestinal tract occur more frequently in the CD group.
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