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Identification and diagnosis of Crohn disease and ulcerative colitis in children
Andrew S Day1,2,3, Daniel A Lemberg2,3
1Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand.
Insights
Inflammatory bowel disease (IBD), including Crohn disease and ulcerative colitis, is increasingly diagnosed in Australasian children. Early recognition of typical and atypical symptoms is crucial for timely diagnosis and management.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Clinical Medicine
Background:
- Inflammatory bowel disease (IBD), encompassing Crohn disease and ulcerative colitis, presents diagnostic challenges in pediatric populations.
- Australasian children exhibit high and increasing incidence rates of IBD.
- Symptoms range from typical gastrointestinal issues to atypical presentations like skin lesions or growth failure, potentially delaying diagnosis.
Purpose of the Study:
- To summarize the current understanding of IBD in Australasian children.
- To highlight diagnostic considerations, including typical and atypical presentations.
- To emphasize the importance of a multidisciplinary approach to IBD management in pediatric patients.
Main Methods:
- Review of clinical presentations, diagnostic workup, and management strategies for pediatric IBD.
- Analysis of epidemiological trends in IBD incidence among children in the Australasian region.
- Synthesis of current evidence regarding diagnostic markers and imaging modalities.
Main Results:
- IBD incidence is rising in Australasian children, with varied clinical presentations.
- Diagnostic delays can occur due to atypical symptoms, underscoring the need for heightened clinical suspicion.
- A comprehensive diagnostic approach involving inflammatory markers, endoscopic, histologic, and radiologic findings is essential.
Conclusions:
- Prompt diagnosis of pediatric IBD requires awareness of both typical and atypical manifestations.
- Integrated, multidisciplinary care is fundamental for optimizing outcomes in children with IBD.
- Continued research into early detection and management strategies for pediatric IBD is warranted.
Abstract:
Crohn disease and ulcerative colitis are the two main types of inflammatory bowel disease. High rates of these conditions are seen in Australasian children - furthermore, increasing rates have been evident in recent years. Children can present with typical symptoms of abdominal pain, diarrhoea, haematochezia and/or weight loss. Atypical presentations (such as skin lesions or isolated short stature) can also occur: these may be associated with delays in the consideration and diagnosis of IBD. Initial steps in establishing a diagnosis of IBD include delineation of inflammatory markers exclusion of any other likely aetiology. Definitive diagnosis relies upon key endoscopic, histologic and radiological findings. Overall management of IBD encompasses care within a team-based, child and family-focused, multi-disciplinary setting.
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