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Presenting phenotype of paediatric inflammatory bowel disease in Wessex, Southern England 2010-2013
J J Ashton1, T Coelho1, S Ennis2
1Department of Paediatric Gastroenterology, University Hospital Southampton, Southampton, UK.
Insights
Paediatric inflammatory bowel disease (PIBD) incidence has doubled, with Crohn's disease and ulcerative colitis presenting similarly to past decades. However, some children show atypical features, normal growth, and normal blood markers.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Clinical Epidemiology
Background:
- The incidence of pediatric inflammatory bowel disease (PIBD) has significantly increased, at least doubling over the past two decades.
- Understanding the current presenting features of PIBD is crucial for timely diagnosis and management.
Purpose of the Study:
- To report the presenting features of PIBD in a UK cohort from 2010 to 2013.
- To compare these features with historical data, given the rising incidence.
Main Methods:
- Retrospective analysis of 172 patients diagnosed with PIBD between 2010 and 2013 at University Hospitals Southampton.
- Data collected from paper and electronic records, including height, weight, and BMI standard deviation scores (SDS).
Main Results:
- Crohn's disease (CD) most commonly presented with abdominal pain (86%), diarrhea (78.5%), and weight loss (56.1%).
- Ulcerative colitis (UC) most commonly presented with blood in stool (92%), diarrhea (92%), and abdominal pain (88%).
- Growth delay was observed in CD patients (height SDS -0.37, weight SDS -1.09), while growth was maintained in UC patients.
Conclusions:
- The phenotype of PIBD remains diverse, despite increasing incidence.
- While classical presentations are frequent, a notable proportion of patients exhibit atypical features, normal growth, and normal blood markers.
Aim:
There has been at least a twofold increase in the incidence of paediatric inflammatory bowel disease (PIBD) over the last 20 years; we report the presenting features from 2010 to 2013 and compare with previous data.
Methods:
All patients diagnosed with PIBD at University Hospitals Southampton from 2010 to 2013 were identified from an in-house database. Data were obtained from paper and electronic notes. Height, weight and BMI SDS are presented as median values (95% CI).
Results:
One hundred and seventy-two patients were included (median age at diagnosis 13.5, 115 male); Crohn's disease (CD) - 107, UC - 50, inflammatory bowel disease unclassified (IBDU) - 15. The most common presenting features of CD were abdominal pain (86%), diarrhoea (78.5%) and weight loss (56.1%); 42.1% of patients had all three. In UC blood in stool (92%), diarrhoea (92%) and abdominal pain (88%) were the most common; all three in 76% of patients. CD presented with ileocolonic disease in 52.5%. UC presented with pancolitis in 64%. There was growth delay in CD: height -0.37 (-0.60 to -0.14); weight -1.09 (-1.35 to -0.83). Growth was maintained in UC: height 0.53 (0.19 to 0.87); weight 0.14 (-0.20 to 0.48).
Conclusion:
Paediatric inflammatory bowel disease phenotype remains as extensive despite increasing incidence. Although the classical phenotype is common, a reasonable proportion present with atypical features, normal growth and normal blood markers.
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