Author
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Motil, Kathleen |
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Submitted to: Book Chapter
Publication Type: Book / Chapter Publication Acceptance Date: 5/26/1997 Publication Date: N/A Citation: N/A Interpretive Summary: Technical Abstract: Inflammatory bowel disease (IBD) is being diagnosed with increasing frequency in young children. Crohn disease or ulcerative colitis will be diagnosed yearly in at least one child less than 5 years of age or in 3 children less than 10 years of age. The severity of symptoms and their relentless progression are worse in the younger child. Hospitalizations will be more frequent and of longer duration and major surgical interventions will be required more frequently and at an earlier age in these patients. The more aggressive course of IBD will have a greater adverse impact on the quality of life in the young child. The growth abnormalities associated with IBD are unique to the young child and demand special attention. Linear stunting may be present in 30% and ponderal wasting may be present in 50% of children with IBD. The growth and nutritional abnormalities are more common in children with Crohn disease than in those with ulcerative colitis. The inflammatory process itself, as opposed to corticosteroid therapy, has a major adverse impact on linear growth rates, the deposition of lean body mass, and bone mineralization in children. The factors that account for the growth and nutritional abnormalities of IBD include inadequate dietary intakes, increased gastrointestinal losses because of diarrhea or malabsorption, and increased nutrient requirements associated with inflammation and catch-up growth. The increased risk of growth and nutritional abnormalities warrants frequent evaluation because of the rapidity with which these adverse consequences may progress in young children. Early, aggressive nutritional intervention reverses the growth and nutritional abnormalities in children with IBD. |
