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(Pediatrics in Review. 2005;26:314-320.)
© 2005 American Academy of Pediatrics

Inflammatory Bowel Disease

The first 300 words of the full text of this article appear below.

	Objectives

 
After completing this article, readers should be able to:

1. Develop a differential diagnosis for the child or adolescent presenting with bloody diarrhea.
   
2. Recognize that growth failure may be the initial presentation of Crohn disease and understand the pathogenesis of this disease complication.
   
3. Describe the manifestations of severe colitis and start appropriate intervention.
   
4. Understand the limitations of corticosteroid therapy for inflammatory bowel disease in children and recognize the need for alternative maintenance therapies.
   

	Introduction

 
Inflammatory bowel disease (IBD) is the generic term used to described two idiopathic disorders associated with gastrointestinal inflammation: Crohn disease (CD) and ulcerative colitis (UC). These disorders need to be distinguished from other conditions that may display similar clinical and laboratory findings, such as infection, allergy, and neoplasm. Because IBD also may be associated with a large array of extraintestinal manifestations, knowledge of the clinical spectrum of these disorders is important to the clinician who may encounter associated problems such as growth delay, arthritis, hepatitis, and anemia. Once IBD is diagnosed, newer medical and surgical treatments allow most affected children to lead relatively normal lives.

	Definitions

 
The definitions of UC and CD are based on the location and characteristics of the inflammatory process within the gastrointestinal tract. In UC, relatively generalized inflammation is confined to the mucosa, starting in the rectum and involving a variable extent of colon proximally. Crypt abscesses are common. Rarely, patients may have discontinuous inflammation at diagnosis or even relative rectal sparing. Over the course of the illness, however, the inflammation becomes more confluent. Inflammation limited to the rectum, observed in 10% of pediatric patients, is termed ulcerative proctitis. In about 30% of cases, the disease is limited to the left side of the colon; in 40% to 50% of cases, there is pancolitis.

The inflammation associated with CD may involve any portion of the . . . [Full Text of this Article]

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