Growth retardation is well described in childhood-onset inflammatory bowel disease (IBD).
To study if childhood-onset IBD is associated with reduced final adult height.
We identified 4201 individuals diagnosed with childhood-onset IBD 1990-2014 (Crohn's disease: n = 1640; ulcerative colitis: n = 2201 and IBD-unclassified = 360) in the Swedish National Patient Register.
Patients with IBD attained a lower adult height compared to reference individuals (adjusted mean height difference [AMHD] -0.9 cm [95% CI -1.1 to -0.7]) and to their healthy siblings (AMHD -0.8 cm [-1.0 to -0.6]). Patients with Crohn's disease (CD) were slightly shorter than patients with ulcerative colitis (UC; -1.3 cm vs -0.6 cm). Lower adult height was more often seen in patients with pre-pubertal disease onset (AMHD -1.6 cm [-2.0 to -1.2]), and in patients with a more severe disease course (AMHD -1.9 cm, [-2.4 to -1.4]). Some 5.0% of CD and 4.3% of UC patients were classified as growth retarded vs 2.5% of matched reference individuals (OR 2.42 [95% CI 1.85-3.17] and 1.74 [1.36-2.22] respectively).
Patients with childhood-onset IBD on average attain a slightly lower adult height than their healthy peers. Adult height was more reduced in patients with pre-pubertal onset of disease and in those with a more severe disease course.
We followed 9602 patients with Crohn's disease or ulcerative colitis for anal squamous cell carcinoma for up to 18 years. No significant increase was observed: two cases occurred vs 1.3 expected during 99,229 person-years of observation, (standardized incidence ratio = 1.6; 95 confidence interval: 0.2-5.7). Anal squamous cell carcinoma is rare even in inflammatory bowel disease.
All patients below 15 y of age living in the eastern part of Denmark with a diagnosis of inflammatory bowel disease (IBD) during the period 1998-2000 were identified (n=94) and anthropometrical data at the time of diagnosis were evaluated.CONCLUSION: The height-for-age and the BMI-for-age, as evaluated by z-scores, of children with ulcerative colitis (UC) did not differ from those of normal Danish children, but Crohn's disease (CD) children had significantly lower height and BMI values, both when compared to normal children and children with UC. In contrast to UC, CD is frequently complicated by malnutrition and growth retardation at the time of diagnosis.
To prospectively follow the evolution of hepatobiliary diseases in a population-based cohort of patients with inflammatory bowel diseases.
Between 2005 and 2009, 790 incident cases of ulcerative colitis and Crohn's disease were registered in the Uppsala Health Region, corresponding to an average incidence of 20.0 and 9.9 new cases/100?000 inhabitants/year, respectively. Liver function tests were analyzed in 97.1% and the results of ensuing investigations were summarized.
Seventeen patients with primary sclerosing cholangitis were diagnosed corresponding to an overall prevalence of 2.2% (ulcerative colitis 1.7% and Crohn's disease 3.0%, respectively). The median age at diagnosis was 25 years (interquartile range: 17.0-34.0). Among the 92 patients below 17 years of age, three had autoimmune hepatitis and three primary sclerosing cholangitis, summing up to a prevalence of 6.5% immune-mediated hepatobiliary diseases among the pediatric patients. Three patients have undergone liver transplantation and one died of colonic carcinoma. Ten patients have demonstrated persistent elevation of alkaline phosphatases but had a normal magnetic resonance cholangiopancreatography (two patients) or refused further investigation (one patient).
In this first large prospective population-based cohort of 526 patients with ulcerative colitis (UC) and 264 with Crohn's disease, 17 cases of primary sclerosing cholangitis were found, among whom three (17%) so far have been liver transplanted and one has died of colon carcinoma. The average age of those affected by primary sclerosing cholangitis is considerably lower than usually reported. Ten patients had or have had elevated alkaline phosphatase without confirmed liver or biliary disease.
We aimed to determine the frequency of fistulizing Crohn's disease (CD) and the relationship between perineal and luminal fistulas.
A population-based retrospective study was conducted by using the University of Manitoba Inflammatory Bowel Disease Research Registry. In 2003 there were 3192 IBD patients, 1595 had (CD), and 398 patients reported stricturing or fistulizing disease. Patients were interviewed and medical records were reviewed for phenotype assessment. Perineal fistulas were defined as those exiting in the perineum or fistulizing to sexual organs. Luminal fistulas were defined as arising from the bowel to organs other than the perineum.
The prevalence of fistulizing CD was at most 22.1%. Of the 398 patients, 280 CD patients were eligible for full phenotype verification. Of these, 50 patients had both perineal and luminal fistulas, 151 had only perineal fistulas, and 79 had only luminal fistulas. Odds ratio (OR) for likelihood of having luminal fistula disease if perineal disease was present was 5.02 (95% confidence interval [CI], 3.40-7.42; P
As for many complex diseases, the incidence of inflammatory bowel disease (IBD) is higher among individuals born during certain seasons. This difference could arise from seasonal variations in many factors, including exposure to sunlight, antibiotics, or infectious agents. We investigated the relationship between season of birth, early childhood exposure to antibiotics, and incidence of IBD.
We performed a nested case-control analysis using data from the University of Manitoba inflammatory bowel disease epidemiology database. We compared seasons of birth among 11,145 individuals with IBD (cases) and 108,633 controls using conditional logistic regression models. We collected data on use of antibiotics in the first year of life for cases and controls from the Manitoba Drug Program Information Network-a comprehensive database of all prescriptions given to residents of Manitoba since 1995.
Approximately 27.0% of cases were born from April through June, compared with 25.6% of controls (odds ratio, 1.07; 95% confidence interval, 1.02-1.12; P = .002). Comparisons made by sex (male vs female) and type of IBD (ulcerative colitis vs Crohn's disease) showed statistical significance only for men with Crohn's disease (odds ratio, 1.13; 95% confidence interval, 1.03-1.25; P = .009). At ages 6 months and older, cases and controls born from April through June received a significantly greater number of prescriptions for antibiotics than cases and controls born in other months.
Men with Crohn's disease are more likely to have been born in the months of April through June.
Inflammatory bowel disease refers to a group of chronic diseases of unknown etiology related to both genetic and environmental factors. In this 1990-1993 study, the authors investigated associations between the content and quality of drinking water and the incidence of inflammatory bowel disease. They used data from a population-based cohort recruited in southeastern Norway and a registry of water quality derived from Norwegian waterworks that contained measurements of iron, aluminum, acidity (pH), color, turbidity, and coliform bacteria. The authors found that risk of developing inflammatory bowel disease, including ulcerative colitis and Crohn's disease, was associated with high iron content. The relative risk of developing inflammatory bowel disease increased by 21% (95% confidence interval: 9, 34) when the iron content in the drinking water increased by 0.1 mg/L. They found no association between the diseases and aluminum in the water, color of the water, and turbidity of the water. The authors suggest that the observations can be explained by 2 mechanisms. First, high iron concentration works as a catalyst for oxidative stress, which will cause inflammation and/or increase the rate of cell mutations. Second, iron content stimulates the growth of bacteria and increases the likelihood of inappropriate immune responses in genetically predisposed individuals.