Aim: Our aim was to describe the characteristics of children with ulcerative colitis (UC) from Schneider Pediatric Inflammatory Bowel Disease (SPID) cohort which was established. In addition, we sought to analyze the occurrence of colectomy in pediatric UC patients during a long-term follow-up and to assess its association with disease severity at diagnosis.
Methods: We performed a chart review using the (SPID) cohort database, including pediatric UC patients.
Results: 705 children diagnosed with IBD between 1981 and 2013 were included, 188 (27%) of whom were diagnosed with UC. Mean age at diagnosis of UC was 12.3 y (range 2-18 y). The initial symptoms were dominated by bloody stools (95%) and diarrhea (77%). Among 188 patients with UC, 33 (18%) underwent proctocolectomy with ileal pouch–anal anastomosis (IPAA). Median follow-up was 8.55 years (range 1-32.7 yr). Median duration from diagnosis to IPAA was 9.6 yr (range 0.27-21.2 yr). Of patients who underwent IPAA, 21 (64%) developed pouchitis; acute in 30%, chronic in 25% and extended (crohn’s like disease) in 9%. Defined by Pediatric UC activity index (PUCAI), 6 % of patients (12/188) had severe disease at diagnosis, 49% (92/188) and 45% (84/188) had moderate and mild disease, respectively. Patients with severe disease at diagnosis had a 50% colectomy rate during follow-up (6/12) compared with 21% (19/92) and 9.5% (8/84) of patients with moderate and mild disease, respectively (p=0.001).
Conclusion: The risk for colectomy was associated with disease severity at diagnosis with a high rate of pouchitis demonstrated in operated patients with IPAA.
