Delays in Diagnosing Pediatric Inflammatory Bowel Disease in Korea: Impact on Disease Severity and the Need for Early Recognition
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So Yoon Choi1, Sujin Choi2, Ben Kang2
1Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea.
Insights
Delayed diagnosis of pediatric inflammatory bowel disease (IBD) in Korea is often due to long waits for the first doctor visit. Increasing public awareness of IBD symptoms is key for earlier detection in children.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Diagnostic Delay Analysis
Background:
- Delayed diagnosis of pediatric inflammatory bowel disease (IBD) is linked to negative health outcomes.
- Understanding diagnostic delays is crucial for improving pediatric IBD patient care.
Purpose of the Study:
- To analyze diagnostic delays in pediatric IBD patients.
- To identify associations between diagnostic delay and disease classification, activity, and initial management.
Main Methods:
- Multicenter retrospective study across 17 Korean medical centers.
- Inclusion of pediatric patients diagnosed with IBD.
- Extraction of clinical and demographic data from medical records.
Main Results:
- 486 pediatric IBD patients included: 362 with Crohn's disease (CD) and 124 with ulcerative colitis (UC).
- Median diagnostic delay did not differ significantly between CD and UC.
- The interval from symptom onset to the first physician visit was significantly longer than from the physician visit to diagnosis for both CD and UC (P=0.004).
- For CD, longer diagnostic delays correlated with fewer extraintestinal symptoms, lower C-reactive protein, and lower symptom scores.
Conclusions:
- Significant diagnostic delays in pediatric IBD are mainly caused by delays in seeking initial medical attention.
- Public awareness campaigns on pediatric IBD symptoms are recommended for early diagnosis in Korea.
- Targeted campaigns could address the growing number of pediatric IBD cases.
Background:
A delayed diagnosis of pediatric inflammatory bowel disease (IBD) can lead to adverse outcomes. This study aimed to analyze the diagnostic delay among pediatric patients with IBD, focusing on associations with disease classification, disease activity, and initial management.
Methods:
This multicenter retrospective study included pediatric patients who had been diagnosed with IBD across 17 Korean medical centers. Clinical and demographic data were extracted from their medical records.
Results:
Overall, 486 patients, 362 with Crohn's disease (CD) and 124 with ulcerative colitis (UC), were included in the study. The median diagnostic delay, defined as the interval between initial symptom onset and final diagnosis of IBD, was not significantly different between CD and UC (P = 0.154); however, the interval from symptom onset to the first physician visit was significantly longer than that from the physician visit to diagnosis for both CD and UC (P = 0.004). Regarding CD, a long diagnostic delay was associated with fewer extraintestinal symptoms, lower C-reactive protein levels, and lower symptom scores.
Conclusion:
Significant diagnostic delays are primarily due to prolonged intervals between symptom onset and the first physician visit. Public awareness campaigns about IBD symptoms tailored to the growing number of pediatric IBD patients in Korea could be a crucial factor for early diagnosis.
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