Growth retardation should suggest Crohn's disease
Faced with a break in the growth curve of children, physicians should immediately think of an inflammatory bowel disease, whose frequency is increasing for several years, pediatricians advise in gastroenterology, hepatology and nutrition.
Professor Olivier Goulet, a pediatrician in the Division of Gastroenterology and Nutrition at the Necker-Enfants Malades Hospital (Paris), gave at a press conference, an inventory of inflammatory bowel in children.
Two major types of inflammatory bowel disease (IBD) are known: Crohn's disease, which affects any part of the digestive tract, and ulcerative colitis, which is still saving the small intestine.
Crohn's disease has about five times higher than the prevalence of ulcerative colitis, with almost one case per 10,000 inhabitants. Pediatric forms represent 15% of all Crohn's disease. For 40 years, the incidence is increasing, now up to 20 new cases per 100,000 people each year, 50% more compared to 1960.
This disease, multifactorial, is still poorly known specialists: they just know that the combination of environmental factors (smoking, infections) and genetic predisposing causes abnormal activation of the intestinal immune system, causing an inflammatory syndrome and tissue damage.
Only a few susceptibility genes have been identified. Approximately one third of patients are carriers. Other genetic mutations, accounting for two-thirds of the remaining cases are being identified. This great diversity of genetic factors involved results in a variety of clinical presentations, which can delay diagnosis.
However, faced with a child with abdominal pain, sometimes with a bloody and mostly stunted chronic diarrhea, it is imperative to quickly consider a problem of inflammatory origin and the first diagnosis that should come to mind of the physician is that of Crohn's disease. To confirm this, endoscopic and radiological examinations are essential.
"The fracture growth reflects the impact of the disease. It begins even before the symptoms," said Dr. Goulet, inviting doctors and pediatricians to carefully monitor the growth curve of the book health of the child to pose the earliest possible diagnosis.
The treatment is both drug-anti-inflammatory put the child in remission, immunosuppressive "avoid the fire restart" - and nutrition (oral preparations to 5 times per day), explained the expert. Corticosteroids should be used with great caution, because of their negative effect on growth.
"We invite all physicians to be very alert to the possibility of this disease," concluded the pediatrician.
Professor Olivier Goulet, a pediatrician in the Division of Gastroenterology and Nutrition at the Necker-Enfants Malades Hospital (Paris), gave at a press conference, an inventory of inflammatory bowel in children.
Two major types of inflammatory bowel disease (IBD) are known: Crohn's disease, which affects any part of the digestive tract, and ulcerative colitis, which is still saving the small intestine.
Crohn's disease has about five times higher than the prevalence of ulcerative colitis, with almost one case per 10,000 inhabitants. Pediatric forms represent 15% of all Crohn's disease. For 40 years, the incidence is increasing, now up to 20 new cases per 100,000 people each year, 50% more compared to 1960.
This disease, multifactorial, is still poorly known specialists: they just know that the combination of environmental factors (smoking, infections) and genetic predisposing causes abnormal activation of the intestinal immune system, causing an inflammatory syndrome and tissue damage.
Only a few susceptibility genes have been identified. Approximately one third of patients are carriers. Other genetic mutations, accounting for two-thirds of the remaining cases are being identified. This great diversity of genetic factors involved results in a variety of clinical presentations, which can delay diagnosis.
However, faced with a child with abdominal pain, sometimes with a bloody and mostly stunted chronic diarrhea, it is imperative to quickly consider a problem of inflammatory origin and the first diagnosis that should come to mind of the physician is that of Crohn's disease. To confirm this, endoscopic and radiological examinations are essential.
"The fracture growth reflects the impact of the disease. It begins even before the symptoms," said Dr. Goulet, inviting doctors and pediatricians to carefully monitor the growth curve of the book health of the child to pose the earliest possible diagnosis.
The treatment is both drug-anti-inflammatory put the child in remission, immunosuppressive "avoid the fire restart" - and nutrition (oral preparations to 5 times per day), explained the expert. Corticosteroids should be used with great caution, because of their negative effect on growth.
"We invite all physicians to be very alert to the possibility of this disease," concluded the pediatrician.
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