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Research Article Open access CC BY 4.0

Growth Failure in Pediatric Inflammatory Bowel Disease: A Preliminary Analysis

A. Al Sahafi, T. Asiri, N. Alageel, M. Hanawi, M. Hassosa

Asian Journal of Pediatric Research · pp. 107–116 · Published 22 Dec 2021

10.9734/ajpr/2021/v7i430229

Abstract

Background: Inflammatory bowel disease (IBD) is a chronic relapsing disease, characterized by chronic inflammation of the gastrointestinal tract (GIT). The incidence of IBD has been increasing over the last two decades, for example, from 1999- 2008 incidence increased from 21.3 to 26.2 per 100,000. Inflammatory bowel disease is mainly classified into two types: Crohn’s disease (CD), and ulcerative colitis (UC). Both types can be identified and distinguished through laboratory tests such as ESR, CRP, and fecal calprotectin, radiographic imaging, and direct visualization via colonoscopy. The etiology of growth failure in IBD, BMI z-score of less than -2.5, is poorly understood; however, chronic inflammation, low-calorie intake, and consequential steroid treatment are the most important factors. This study aims to determine the incidence of growth failure and associated factors in pediatric patients with IBD. Methods: This was a retrospective cohort study of children aged 15 years and below, with the diagnosis of IBD. Data were obtained from the pediatric gastroenterology department pediatric inflammatory bowel disease database from 2007 to 2017. Our study identifies the prevalence of growth failure via a calculated BMI z-score of less than -2.5 among the pediatric inflammatory bowel disease (PIBD) population. The Chi-square test is used for categorical data and Wilcoxon rank-sum test for continuous data.  A p-value <0.05 was considered statistically significant. All analyses were carried out with Stata IC/15.1 (StataCorp LP, College Station, TX, USA). Results: A total of 36 patients were included. The mean age of children with growth failure at the time of IBD diagnosis was 8 (±4), and more than half of them (58.3%) were boys. The incidence of growth failure at the time of diagnosis was 22.2% and declined to 11.1% over 26 months. Furthermore, the mean BMI z-score gradually improved from -0.741 to -0.1 over the same period of follow-up after proper management and multidisciplinary involvement. Conclusion: Growth failure in IBD patients according to our data is uncommon, however, it was reduced by 50% over 26 months. This could be attributed to nutritional status improvement over the management period. We recommend following the stepwise approach according to the severity of the disease and managing IBD patients by a multidisciplinary team. However, due to the relatively small sample size and low growth failure incidence, a large-scale study is recommended to determine any causal relations.

Inflammatory bowel disease crohn’s disease ulcerative colitis pediatric growth failure.

References (15)

  1. 1 Development and Validation of a Pediatric Crohn's Disease Activity Index [DOI]
  2. 2 Epidemiology of pediatric inflammatory bowel disease: A systematic review of international trends [DOI]
  3. 3 Natural History of Pediatric Crohn's Disease: A Population-Based Cohort Study [DOI]
  4. 4 Trends in Epidemiology of Pediatric Inflammatory Bowel Disease in Canada: Distributed Network Analysis of Multiple Population-Based Provincial Health Administrative Databases [DOI]
  5. 5 Appraisal of the pediatric ulcerative colitis activity index (PUCAI) [DOI]
  6. 6 Guidelines for the management of growth failure in childhood inflammatory bowel disease [DOI]
  7. 7 Mechanisms of growth impairment in pediatric Crohn's disease [DOI]
  8. 8 Increasing Incidence of Paediatric Inflammatory Bowel Disease in Northern Stockholm County, 2002–2007 [DOI]
  9. 9 Longitudinal Growth in Children and Adolescents with Inflammatory Bowel Disease [DOI]
  10. 10 Lipopolysaccharide exposure is linked to activation of the acute phase response and growth failure in pediatric Crohnʼs disease and murine colitis [DOI]
  11. 11 Biologic Agents Are Associated with Excessive Weight Gain in Children with Inflammatory Bowel Disease [DOI]
  12. 12 Diagnostic Considerations in Pediatric Inflammatory Bowel Disease Management.
  13. 13 Malnutrition in inflammatory bowel disease patients in northern India: frequency and factors influencing its development.
  14. 14 High body mass index is not associated with increased treatment failure in infliximab treated pediatric patients with inflammatory bowel disease [DOI]
  15. 15 Variation in Care in Pediatric Crohn Disease [DOI]

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