Related Experiment Video
Updated: Dec 20, 2025
A TNBS-Induced Rodent Model to Study the Pathogenic Role of Mechanical Stress in Crohn's Disease
Published on: March 1, 2022
Inflammatory Bowel Disease in Children: Experience and Constraints in a Resource-limited Setting
Oluwafunmilayo F Adeniyi1,2, Emuobor Odeghe3, Foluke A Olatona4
1Pediatrics/Gastroenterology, College of Medicine, University of Lagos, Lagos, NGA.
Insights
Inflammatory bowel disease (IBD) is rare in Nigerian children but requires high suspicion for early diagnosis. Management is challenging due to limited resources and diagnostic tools in Nigeria.
Area of Science:
- Pediatric gastroenterology
- Gastrointestinal diseases
- Inflammatory bowel disease (IBD)
Background:
- Inflammatory bowel disease (IBD) is infrequently diagnosed in Black African children compared to Caucasian populations.
- This study addresses the emerging challenge of IBD in African children and its management constraints in resource-limited settings like Nigeria.
Purpose of the Study:
- To enhance awareness of inflammatory bowel disease (IBD) in African children.
- To highlight the challenges in diagnosing and managing IBD in resource-limited settings.
Main Methods:
- A retrospective audit of pediatric IBD cases at Lagos University Teaching Hospital (LUTH) from January 2015 to February 2020.
- Review of clinical records for children aged 1-16 years presenting with symptoms suggestive of IBD.
- Documentation of clinical features, endoscopic findings, histopathology, and treatment protocols.
Main Results:
- Eight pediatric IBD cases were identified, with a median age of 12 years.
- Common symptoms included chronic abdominal pain (50%) and bloody diarrhea (42.30%).
- Endoscopy revealed Crohn's disease (CD) in 2, ulcerative colitis (UC) in 3, and indeterminate colitis (IC) in 3 cases. Treatment varied based on diagnosis, including steroids, enteral nutrition, methotrexate, and 5-aminosalicylates.
Conclusions:
- Early diagnosis of IBD in Nigerian children necessitates a high index of suspicion.
- Management is significantly hampered by restricted access to endoscopy and the unavailability of advanced therapies like biologic agents.
Introduction:
Inflammatory bowel disease (IBD), though well described in the Caucasian population, is rarely encountered in the black African children. The aim of this study was to increase the awareness of this emerging condition in African children and highlight the constraints of management in a resource-limited setting like Nigeria.
Methods:
This study included an audit of children with IBD who were seen between January 2015 and February 2020 at the Lagos University Teaching Hospital (LUTH). The clinical records of children aged one to 16 years who presented with recurrent abdominal pain, weight loss, and gastrointestinal (GI) bleeding with clinical suspicion of IBD were reviewed. Clinical features, endoscopic findings, histopathologic findings, and treatment were documented.
Results:
Eight children with IBD were seen during the study period. The median age was 12.0 years (range: five to 15 years). The most common reported concerns in the children were chronic abdominal pain [seen in four patients (50%)] and bloody diarrhea [seen in three patients (42.30%)]. Weight loss and arthritis were seen in three (37.5%) and one (12.5%) children, respectively. Endoscopy confirmed two cases of Crohn's disease (CD), three cases of ulcerative colitis (UC), and three cases of indeterminate colitis (IC). The children with CD were treated with steroids and exclusive enteral nutrition, with one patient receiving methotrexate, while the UC and IC patients received 5-aminosalicylate therapy.
Conclusion:
Although IBD is uncommon in Nigeria, a high index of suspicion is vital to enable early diagnosis and appropriate treatment. Management in the African setting is severely constrained by limited access to endoscopy facilities and nonavailability of other effective treatment options such as biologic agents.
Related Concept Videos
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...