Paediatric Inflammatory Bowel Disease from 2008 to 2018: An Expending Problem in our Tertiary Unit

Background: The last two decades rapidly risen in the incidence and prevalence of childhood-onset inflammatory bowel disease (IBD) has demanded many research debates. Both developed and developing countries are facing the burden of early onset IBD, although previously it was considered to be rare in children.

Objectives: The aim of our study was to evaluate the characteristics of paediatric IBD patients recorded over a 10 year period, 2008-2018.

Methods: We identified children diagnosed with IBD using the database of „Grigore Alexandrescu” Clinical Emergency Hospital, a tertiary unit, from Bucharest, the capital of Romania.

Results: The total number of IBD paediatric cases investigated in our Department over a 10 years period is 74. In this interval, 62 patients (20 males/42 females= 0.477) were diagnosed with UC and 12 subjects had CD (7 males/ 5 females=1.4). The sex difference was not significant for neither CD nor UC (p>0.05). The median age in years was 11.4±4.83 for IBD, 11.32±4.86 for UC, 11.81±4.87 for CD. The median age at diagnosis did not differ between CD and UC (p˂0.005), and evaluation regarding sex showed no significant differences between the age at onset in boys and girls (p˂0.005). The mean duration of time between age at first symptoms and diagnosis was 5.02±7.96, 4.96±8.33 and 5.33±6.00 months for IBD, UC and CD respectively. We report 17.6% patients with very early onset IBD, while the previous data from 2004 to 2015 showed 33% being diagnosed before the age of 6. In the last 3 years we identified 40 newly diagnosed IBD cases with mean age at diagnosis of 13.61±3.07 years.

Conclusion: Future studies should investigate the epigenetic factors, such as antibiotics use in the first years of life, feeding patterns and infections, among our paediatric IBD cohort, considering its increasing incidence and changing patterns over time.