Retrospective evaluation of our patients with inflammatory bowel disease Original Article

Abstract

In 20 of inflammatory bowel disease cases the complaints begin in childhood Aim: This study aims to nbsp; evaluate the diagnosedas inflammatory bowel disease in our clinic between of November 1990 and November 2006 Material and Method: We evaluated the diagnostic and therapeutic properties of 38 cases diagnosedas inflammatory bowel disease in our pediatric gastroenterology hepatology and nutrition clinic retrospectively Results: 31 cases were diagnosedas ulcerative colitis 7 of them were diagnosedas Crohn’s disease The average age of the cases at the onset of diagnosis was 9 1 years; 10 5 years in Crohn’s disease and 8 5 years in ulcerative colitis The mean duration until the diagnosis was mode 5 1 months 6 8 months in Crohn’s disease 4 5 months in ulcerative colitis The most common application complaints were bloody stools abdominal pain diarrhea and weight loss Conclusions: Growth retardation and abdominal pain are more significant symptoms in Crohn’s disease 71 whereas bloody stools are more common in ulcerative colitis 87 In childhood ileo colonic involvement is more common in Crohn’s disease and total colonic involvement is observed in ulcerative colitis commonly Turk Arch Ped 2007; 42: 65 9 Key words: Child nbsp; inflammatory bowel disease

Keywords

• -

Enflamatuvar bağırsak hastalarımızın geriye dönük olarak değerlendirilmesi Orijinal Araştırma

Öz

Enflamatuvar bağırsak hastalığı nbsp; olgularının 20’sinde yakınmalar çocukluk yaş döneminde başlar Amaç: Bu çalışmada Kasım1990 ve Kasım 2006 tarihleri arasında bilim dalımızda enflamatuvar bağırsak hastalığı tanısıyla izlenen olguları değerlendirmeyi amaçladık Gereç ve Yöntem: Çocuk Gastroenteroloji Bilim Dalımızda enflamatuvar bağırsak hastalığı tanısı ile izlenen 38 olgunun tanı özellikleri ve tedavileri geriye dönük olarak değerlendirildi Bulgular: Olgularımızın 31’i ülseratif kolit yedisi Crohn hastası idi Tanı sırasındaki yaş ortalamaları 9 1 yaş idi Crohn hastalığında yaş ortalaması 10 5 yaş ülseratif kolitte 8 4 yaş idi Tanı alıncaya kadar geçen süre ortalama 5 1 ay olup Crohn hastalığında 6 8 ay ülseratif kolitte 4 5 ay olarak bulundu En sık başvuru yakınmaları kanlı dışkılama karın ağrısı ishal ve kilo kaybı idi Çıkarımlar: Büyüme geriliği ve karın ağrısı Crohn hastalığında 71 kanlı dışkılama ülseratif kolitte 87 daha belirgindir Çocukluk çağında ülseratif kolitin pankolitle Crohn hastalığının ileo kolonik tutulumla görülme sıklığı daha fazladır Türk Ped Arş 2007; 42: 65 9 Anahtar kelimeler: Çocuk enflamatuvar bağırsak hastalığı

Anahtar Kelimeler

• -

References

1. Andus T, Gross V. Etiology and pathophysiology of inflamma- tory bowel disease: enviromental factors. Hepatogastroente- rology 2000; 47: 29-43.
2. Binder V. Genetic epidomiology of inflammatory bowel dise- ase. Dig Dis 1998;16: 351-5.
3. Barbieri D. Inflammatory bowel disease. J Pediatr 2000; 76: 173-80.
4. Crohn BB. Ginzburg L, Oppenheimer GD. Regional ileitis: a pathologic and clinical entity. JAMA 1932; 99: 1323-9.
5. Olafsdottir EJ, Fluge G, Haug K. Chronic inflammatory bowel disease in children in Western Norway. J Pediatr Gastroente- rol Nutr 1989; 8: 454-8.
6. Andres PG, Friedman LS. Epidemiology and natural course of inflammatory bowel disease. Gastroenterol Clin North Am 1999; 28: 255-81.
7. Mamula P, Markowitz JE, Baldassano RN. Inflammatory bowel disease in early childhood and adolescence: special con- siderations. Gastroenterol Clin North Am 2003; 32: 967-95.
8. Esher JC, Dias A, Bochenek K, et al. Inflamatory bowel disease in children and adolescents: recommendations for diagnosis- the Porto criteria. J Pediatr Gastroenterol Nutr 2005; 47:1-7.

9. Hyams JS. Inflamatory bowel disease. Pediatrics 2000; 21: 291-5.
10. Russel MG, Stockbrugger RW. Epidemiology of inflammatory bowel disease: an update. Scand J Gastroenterol 1996; 31: 427-9.
11. Mamula P, Telega GW, Markowitz JE, et al. Inflamatory bowel disease in children 5 years of age and younger. Am J Gast- roenterol 2002; 97: 2005-10.
12. Sawczenko A, Sandhu BK, Logan RFA, et al. Prospective sur- vey of childhood inflammatory bowel disease in British Isles. Lancet 2001; 357: 1093-4.
13. Weinstein TA, Lenine M, Pettei MJ, et al. Age and family his- tory at presentation of pediatric inflammatoy bowel disease . J Pediatr Gastroenterol Nutr 2003; 37: 609-13.
14. Gryboski JD. Crohn’s disease in children 10 years old and younger: comparaison with ulserative colitis. J Pediatr Gast- roenterol Nutr 1994; 18: 174-82.
15. Kutlu T, Gülcan EM, Çullu F, et al. Çocukluk çağında enf- lamatuvar bağırsak hastalığı. Turk Ped Arş 2000; 35: 102-7.
16. Michener WM, Whelan G, Greenstreet RL, et al. Comparasion of clinical features of Crohn’s disease and ulcerative colitis with onset in childhood or adolescence. Clevel Clin Q 1982; 49: 6-13.
17. Gasche C, Scholmerich J, Bryskov J, et al. A simple clas- sification of Crohn’s disease: report of Working Party for the World Congresses of Gastroenterology. Inflamm Bowel Dis 2000; 6: 8-15.
18. Kanof M, Lake M, Bayless T. Decreased height velocity in children and adolescencts before the diagnosis of Crohn’s dis- ease. Gastroenterology 1988; 95: 1523-7.
19. Watson AJ, Johnston AT, Barker PM, et al. The presentation and management of juvenile-onset chronic inflammatory bowel disease in Northeastern Scotland. J Pediatr Surg 2002; 37: 83-6
20. Su CG, Judge TA, Linchtenstein GR. Extraintestinal manifes- tations of inflammatory bowel disease. Gastroenterol Clin N Am 2002; 31: 306-27.
21. Hendrickson BA, Gokhale R, Judy H. Clinical aspects of inf- lammatory bowel disease. Clin Microbiol Rev 2002; 15: 79-94.
22. Greenfild C, Ramirez AJR, Pounder RE, et al. Clostridium dif- ficile and inflamatory bowel disease. Gut 1983; 24: 713-7.
23. Cabrera-Abreu JC, Davies P, Matek Z, et al. Performance of blood tests in diagnosis of inflammatory bowel disease in spe- cialist clinic. Arch Dis Child 2004; 89: 69-71.
24. Zholudev A, Zurakowski D, Young W, et al. Serologic testing with ANCA, ASCA and anti-OmpC in children and young adults with Crohn’s disease and ulcerative colitis: diagnostic value and correlation with disease phenotype. Am J Gastroen- terol 2004; 99: 2253-341.
25. Griffiths AMB, Büller HA. Inflammatory bowel disease. In: Wal- ker WA, Durıe PR, HamiltonJR, Waker- Smith JA, Watkins JB (eds). Pediatric Gastrointestinal Disease: Pathophysiology, Diagnosis, Management. Third ed. Philadelphia: BC Decker Inc, 2000: 613-51.
26. Sawczenko A, Sandhu BK. Presenting features of inflam- matory bowel disease in Great Britain and Ireland. Arch Dis Child 2003; 88: 995-1000.
27. Castellaneta SP, Afzal NA, Grenberg M, et al. Dignostic role of upper gastrointestinal endoscopy in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2004; 39: 257-61.
28. Lipson A, Bartram CI, Willams CB, et al. Barium studies and ileoscopy compared in children with suspected Crohn’s dis- ease. Clin Radiol 1990; 41: 5-8.
29. Kirschner BS. Differences in the management of inflammatory bowel disease in children and adolescents compared to adults. J Med 1998; 53: 8-13.
30. Stein RB, Hanauer SB. Medical therapy for inflammatory bowel disease. Gastroenterol Clin North Am 1999; 28: 297-332.