Pediatric colitis is an inflammatory bowel disease (IBD) associated with two major disease states: Pediatric ulcerative colitis (UC) and pediatric Crohn's disease (CD). While IBD can effect individuals of any age, a review article in the July/August 2007 issue of "Gastroenterolyogy Nursing" states that children and adolescents account for approximately 300,000 diagnosed cases in the United States alone. Though almost all children with IBD exhibit general symptoms, UC and CD symptoms are diverse and complex, and may manifest in varying regions of the body such as the intestine, joints, eyes or skin.
General Symptoms
Children with pediatric IBD may exhibit such symptoms as abdominal/stomach pain, bloating, diarrhea, nausea, fatigue, and weight loss. These symptoms are the result of ulcer formation within the lining of the digestive tract, which may also cause fever, bloody stools, and a decrease in appetite in some children. In the May 28, 2006 issue of the "World Journal of Gastroenterology," Drs. Diefenbach and Breuer note that children with IBD also often have vitamin deficiencies, such as iron and vitamin B12, due to poor nutrient absorption from ingested food. These vitamin deficiencies can lead to growth and developmental delays, anemia, jaundice, osteopenia, or osteoporosis in some children.
Extraintestinal Symptoms
According to an article in the November 2007 issue of "Inflammatory Bowel Disease," approximately 20 to 40 percent of all IBD patients develop symptoms outside of the intestine. Such symptoms are termed extraintestinal manifestations (EIM), and can effect the joints, eyes, skin and biliary tract. In children, EIMs may develop before any intestinal symptoms appear, which can make pediatric IBD a difficult disease to diagnose.
Joints
Joint inflammation is the most common EIM and--according to Drs. Diefenbach and Breuer--affects approximately 7 to 25 percent of children with IBD. Joint symptoms can range in severity from relatively mild, such as arthralgia, to severe, such as acute arthritis. The location of joint pain may also vary; peripheral arthritis causes pain within the joints of the arms or legs, while axial arthritis causes pain along the spinal column.
Eyes
Inflammatory eye conditions occur in approximately 2 to 6 percent of patients with IBD, according to the November 2007 issue of "Inflammatory Bowel Disease." Episcleritis causes increased blood flow to certain regions of the eye, but is painless and does not cause any visual problems. Uveitis, however, causes painful swelling within the middle region of the eye, which can lead to blurred vision.
Skin
Inflammatory skin lesions are frequently experienced by IBD patients. Drs. Diefenbach and Breuer state that erythema nodosum, a disorder in which inflamed red bumps appear on the skin of the face, body or front of the legs, occurs in approximately 3 percent of children with IBD. Children may also develop severe, painful skin inflammation on the shins that can develop into ulcers, a condition called pyoderma gangrenosum.
Biliary Tract
Inflammation of the biliary tract---the bile transport pathway---can cause problems associated with the liver, pancreas, gallbladder and kidneys in IBD patients. An article in the Aug.14, 2006 issue of the "World Journal of Gastroenterology" states that approximately 3 percent of patients with IBD have chronic inflammation of the biliary tract, a condition called primary sclerosing cholangitis. Five percent of pediatric IBD patients develop kidney stones, while gallstones, pancreatitis and liver malfunction may also be seen these patients.
References
- The Children's Hospital of Philadelphia
- Barrie A, Regueiro M. Biologic therapy in the management of extraintestinal manifestations of inflammatory bowel disease. Inflamm Bowel Dis. 2007 Nov;13(11):1424-9. Review. PubMed PMID: 17567879.
- Rothfuss KS, Stange EF, Herrlinger KR. Extraintestinal manifestations and
