Gastroenterology
Inflammatory bowel disease
The term chronic inflammatory bowel disease (IBD) summarizes the clinical pictures of ulcerative colitis and Crohn's disease, which are not always clearly distinguishable from one another. The inflammation often occurs in bouts, but there are also continuous courses. The main symptom of chronic inflammatory bowel disease is chronic diarrhoea, accompanied by abdominal cramps. Some patients report more than 20 bowel movements per day. The chronic inflammation attacks the healthy intestinal tissue. Abscesses, fistulas, and stenoses can be additional complications.8
An overview of gastroenterological diseases
Crohn's disease (MC)
Along with ulcerative colitis (CU), Crohn's disease (MC) is the most common chronic inflammatory bowel disease, where all layers of the intestine wall can be inflamed. Crohn's disease can affect any part of the digestive tract, from the mouth to the anus. Most often, Crohn's disease is found in the terminal small intestine (terminal ileum).7
Paediatric Crohn's disease
Crohn's disease is a chronic inflammatory bowel disease (IBD) that usually occurs in episodes and shows up in up to a quarter of those affected in childhood or adolescence.1 The inflammation usually occurs at the transition from the small intestine to the large intestine. However, it can also affect the entire digestive tract from mouth to anus.2 The most common symptoms are chronic abdominal pain, diarrhoea, and weight loss.1,2,3 Children and adolescents can also experience stunted growth and delayed puberty.4,5 All of these factors can severely impair the quality of life and even lead to depression.6
Ulcerative colitis (CU)
Ulcerative colitis (CU) is the most common chronic inflammatory bowel disease along with Crohn's disease (MC). In ulcerative colitis, blood and mucus are often observed. The chronic inflammation in ulcerative colitis is limited to the area of the large intestine and is characterized by the formation of ulcerations on the superficial layers of the mucous membrane (mucosa and submucosa).8
Paediatric ulcerative colitis (CU) in children and adolescents
The incidence of ulcerative colitis can differ considerably in adult and paediatric patients. A manifestation of this chronic inflammatory bowel disease in childhood or adolescence is more often associated with an aggressive course, which can manifest itself in extensive colitis and in many cases requires hospitalization.9
The incidence of the disease in Germany is between 3.0–3.9 per 100,000 inhabitants.10
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Sources
1. Griffiths AM Best Pract Res Clin Gastroenterol. 2004 Jun; 18 (3): 509-23.
2. Baumgart DC, Sandborn WJ Lancet. 2012 Nov 3; 380 (9853): 1590-605.
3. Preiss JC et al. Z Gastroenterol 2014; 52: 1431-1484.
4. Walters TD, Griffiths AM Nat Rev Gastroenterol Hepatol. 2009; 6: 513-23.
5. Markowitz J et al. J Pediatr Gastroenterol Nutr. 1993; 16: 373-80.
6. Greenley RN et al. J Pediatr Psychol. 2010; 35: 857-69.
7. AWMF. Patient guideline "Crohn's disease, diagnostics and therapy", 2014
8. German Crohn's Disease / Ulcerative Colitis Association https://www.dccv.de/habene-angehoerige/medizinische-grundlagen/was-ist-colitis-ulcerosa/ , as of February 3, 2020
9. Turner D et al. Management of Pediatric Ulcerative Colitis, Part 1: Ambulatory Care-An Evidence-based Guideline From European Crohn's and Colitis Organization and European Society of Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2018; 67: 257-291.
10. Däbritz J et al. Dtsch Ärztebl Int 2017; 114 (19): 331-330.