Paediatric inflammatory bowel disease in a multiracial Asian country.

Abstract

INTRODUCTION:

This study examined the characteristics and trends in the incidence of inflammatory bowel disease (IBD) among children in Singapore.

METHODS:

We retrospectively reviewed all patients under 18 years diagnosed with IBD over a 14-year period. Information on demographics, disease presentation, laboratory findings, radiological investigations, and endoscopic and histological findings were obtained from the patients' medical records.

RESULTS:

32 patients were diagnosed with IBD, 30 of whom had Crohn's disease and 2 had ulcerative colitis. The incidence of IBD rose from an initial rate of 2.2 per 100,000 patients in the year 2000 to a peak of 11.4 patients per 100,000 patients by 2008. Median age of onset of symptoms was 10.5 years. There were more boys (63%) than girls in the group and a higher representation of Indians (34.4%). The most common presenting symptoms were abdominal pain (87.5%), diarrhoea (75.0%) and weight loss (71.9%). Extraintestinal manifestations such as fever and arthralgia were found in over 50% of patients. The most common physical findings were perianal abnormalities (56.3%), mouth ulcers (37.5%) and growth failure (15.6%). Abnormal laboratory findings such as low albumin, raised erythrocyte sedimentation rate, anaemia, thrombocytosis and high C-reactive protein were found in nearly half of the patients. Endoscopic and histological findings showed that a majority of patients (90.6%) also had evidence of inflammation in the upper gastrointestinal tract.

CONCLUSION:

Paediatric IBD is on the rise. The higher occurrence in Indians, earlier onset and more florid presentation may suggest different genetic and environmental influences specific to Asian children.

• Authors: Hui Ping Chu, Veena Logarajah, Nancy Tan, Kong Boo Phua
• Journal: Singapore medical journal (Singapore Med J) Vol. 54 Issue 4 Pg. 201-5 (Apr 2013) ISSN: 0037-5675 [Print] India
• PMID: 23624446 (Publication Type: Journal Article)

Topics

• Adolescent
• Age of Onset
• Child
• Child, Preschool
• Colitis, Ulcerative (diagnosis)
• Crohn Disease (diagnosis)
• Environment
• Ethnicity
• Female
• Genetic Predisposition to Disease
• Humans
• Inflammation
• Inflammatory Bowel Diseases (diagnosis, epidemiology, ethnology, therapy)
• Male
• Retrospective Studies
• Singapore (epidemiology)
• Treatment Outcome