Pediatric Practice Gastroenterology by Warren P. Bishop

Author:Warren P. Bishop [Bishop, Warren P.]
Language: eng
Format: mobi
Publisher: McGraw-Hill Education
Published: 2010-10-06T04:00:00+00:00

Weight Loss

Weight loss is a major problem in CD; over 80% of patients have some degree of weight loss at presentation.14 The cause is probably multifactorial, but is mostly due to poor nutritional intake. Many children have decreased appetite/intake due to pain or increased stools. Adding to this, they can have decreased nutritional absorption due to small bowel disease. A higher metabolic state due to chronic inflammation may have some contribution as well.

Growth Failure

Growth failure is a critical concern in childhood-onset IBD. It is important for physicians to know that growth impairment can be the only presenting sign of CD, even before GI symptoms manifest (Figure 16–1).15 In a child with decreased height velocity or lack of growth, IBD should be on the differential diagnosis. About 30% of pediatric CD patients and 6% of UC patients will have growth failure at presentation.16 It has been shown that the majority of early onset CD patients (onset prior to puberty) have reduced adult height.17 Growth failure is more pronounced in boys than girls for unknown reasons.14 The cause of persistent growth failure is multifactorial, including nutritional deficits, malabsorption, increased metabolic demands, medications, and possibly other unknown mechanisms.

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