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Expert consensus on diagnostic guidelines for pediatric inflammatory bowel disease in Japan
Takahiro Kudo1, Katsuhiro Arai2, Itaru Iwama3
1Department of Pediatrics, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. t-kudo@juntendo.ac.jp.
Insights
Pediatric inflammatory bowel disease (IBD) presents uniquely in children. This review synthesizes global standards and Japanese clinical experience to aid diagnosis and management of pediatric IBD.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
Background:
- Pediatric inflammatory bowel disease (IBD) often presents with atypical symptoms and a more severe course compared to adults.
- Recognizing age-specific differences in IBD presentation, diagnosis, and evaluation is crucial for children.
- The European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) revised Porto criteria (2014) are globally utilized for pediatric IBD diagnosis.
Purpose of the Study:
- To support the development of formal diagnostic guidelines for pediatric IBD in Japan.
- To summarize key diagnostic considerations and clinical practices for pediatric IBD within the Japanese context.
Main Methods:
- A review synthesizing international diagnostic guidelines for IBD.
- Incorporation of expert opinions from Japanese pediatric gastroenterologists.
- Outline of essential clinical and laboratory evaluations, treatment, and follow-up strategies.
Main Results:
- Summarized recommended diagnostic tests for children with suspected IBD.
- Highlighted critical clinical points requiring special attention in pediatric IBD.
- Reflected a blend of global standards and domestic clinical experience in Japan.
Conclusions:
- This review provides practical information for diagnosing and managing pediatric IBD in Japan.
- It aims to guide physicians and patients, despite not establishing formal diagnostic criteria or evidence levels.
Background:
Inflammatory bowel disease (IBD) can occur at any age. In pediatric patients, the disease may present with a broader range of symptoms and more severe course than in adults, due to ongoing growth and development. Therefore, pediatric IBD often exhibits an atypical clinical course and laboratory findings. It is essential to recognize differences in disease presentation, differential diagnoses, and evaluation strategies specific to children. The revised Porto criteria, proposed by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) in 2014, are widely used globally, including in Japan, for the diagnosis of pediatric IBD.
Purpose:
Despite the widespread use of these criteria, no formal diagnostic guidelines for pediatric IBD have been developed in Japan. We aimed to support future guideline development by summarizing important diagnostic considerations and clinical practices for pediatric IBD in Japan.
Methods:
This review was developed based on relevant international diagnostic guidelines and the expert opinions of Japanese pediatric gastroenterologists. It outlines key clinical and laboratory evaluations, as well as current treatment and follow-up approaches.
Results:
We summarized recommended diagnostic tests and clinical points that require special attention in children with suspected IBD. The article reflects both global standards and domestic clinical experience.
Conclusion:
Although this article does not provide formal diagnostic criteria or assess evidence levels, it offers accurate and practical information to guide physicians and patients in the diagnosis and management of pediatric IBD in Japan.
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