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Crohn's disease in childhood
Archives of Disease in Childhood
|August 1, 1977
Summary
Pediatric Crohn's disease often presents with common GI symptoms, but also unexplained fever and growth failure. Early diagnosis and surgical intervention are recommended due to high relapse rates and significant impact on growth and education.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
Background:
- Crohn's disease (CD) is a chronic inflammatory bowel disease.
- Pediatric-onset CD presents unique challenges in diagnosis and management.
Observation:
- Common symptoms in pediatric CD include abdominal pain, diarrhea, and weight loss.
- Unexplained fever and failure to grow were prominent, with stunted growth being the most frequent physical abnormality.
- A significant delay in diagnosis, averaging almost 3 years, was observed.
Findings:
- The primary reason for diagnostic delay was the failure to consider Crohn's disease and perform barium follow-through examinations.
- Both medical therapy and surgical resection resulted in high cumulative relapse rates.
- Surgically treated patients experienced a longer median relapse time compared to medically treated patients.
Implications:
- Early surgical intervention is recommended for pediatric Crohn's disease, particularly in growth-retarded patients or those experiencing educational disruption.
- Timely diagnosis is crucial to mitigate long-term complications such as stunted growth and academic underachievement.
- Further research into optimizing management strategies for pediatric Crohn's disease is warranted to improve patient outcomes.