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Inflammatory bowel disease in infancy: an increasing problem?

I M Dady1, A G Thomas, V Miller

  • 1Department of Paediatric Gastroenterology, Booth Hall Childrens' Hospital, Manchester, England.

Journal of Pediatric Gastroenterology and Nutrition
|December 1, 1996
PubMed
Summary
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Infantile inflammatory bowel disease (IBD) presents a diagnostic challenge, often unresponsive to standard treatments. This study highlights severe, treatment-resistant IBD cases in infants, emphasizing the need for further research.

Area of Science:

  • Pediatric Gastroenterology
  • Inflammatory Bowel Disease Research
  • Infant Health

Background:

  • Intractable diarrhea in infancy can indicate severe gastrointestinal pathology.
  • Inflammatory bowel disease (IBD) is rare in early infancy.
  • Distinguishing IBD from other causes of infant diarrhea is crucial.

Observation:

  • Seven infants presented with intractable diarrhea and endoscopically confirmed IBD between 1990-1993.
  • Patients showed varied symptoms including mouth ulcers, upper GI inflammation, villous atrophy, and colitis.
  • Disease was unresponsive to bacterial infection exclusion and whole protein exclusion diets.

Findings:

  • Significant clinical and histological heterogeneity was observed among the seven patients.
  • All infants required parenteral nutrition due to the severity of their condition.

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  • Treatment outcomes were poor: only one patient responded to steroids, two needed colectomy, and two died.

    • Implications:

    • Infantile IBD, distinct from infectious or milk-intolerance causes, is a rare but serious condition.
    • The increasing prevalence of IBD in infancy warrants further investigation.
    • Management of severe infantile IBD requires specialized, often intensive, care and highlights treatment limitations.