Abstract
A thorough history and physical examination are the key steps in the diagnosis of inflammatory bowel disease (IBD). While abdominal pain, weight loss, rectal bleeding, and diarrhea are the usual symptoms associated with IBD, the presentation may differ between Crohn disease and ulcerative colitis. Children may have unique presenting symptoms like short stature, delayed puberty, or extraintestinal manifestations. Patient awareness of symptoms may vary widely. A careful history can often yield the diagnosis, but sometimes a high index of suspicion is required to recognize atypical presentations.
Physical examination complements the history to provide a detailed assessment of the patient’s condition and confirm suspicions of the disease and its complications. Children may exclusively present with short stature or failure to thrive, so height and weight evaluation is important in both the initial as well as subsequent assessment of patients with IBD. A complete physical exam including perianal inspection and if possible a digital rectal exam is crucial in the evaluation of a child with suspected or established IBD. Together, a comprehensive history and physical examination form the foundation for initial diagnosis and follow-up care of a child with IBD.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
IBD Working Group of the European Society for Paediatric Gastroenterology Hepatology and Nutrition. Inflammatory bowel disease in children and adolescents: recommendations for diagnosis – the Porto criteria. J Pediatr Gastroenterol Nutr. 2005;41(1):1–7.
Kugathasan S, Judd RH, Hoffmann RG, et al. Epidemiologic and clinical characteristics of children with newly diagnosed inflammatory bowel disease in Wisconsin: a statewide population-based study. J Pediatr. 2003;143(4):525–31.
Sawczenko A, Sandhu BK. Presenting features of inflammatory bowel disease in Great Britain and Ireland. Arch Dis Child. 2003;88(11):995–1000.
Miller LC, Sisson BA, Tucker LB, et al. Prolonged fevers of unknown origin in children: patterns of presentation and outcome. J Pediatr. 1996;129(3):419–23.
Paraskevi V. Voulgari. Rheumatological manifestations in inflammatory bowel disease. Annals of Gastroenterology. 2011;24:173–80.
Heyman MB, Kirschner BS, Gold BD, et al. Children with early-onset inflammatory bowel disease (IBD): analysis of a pediatric IBD consortium registry. J Pediatr. 2005;146(1):35–40.
Uhlig HH. Monogenic diseases associated with intestinal inflammation: implications for the understanding of inflammatory bowel disease. Gut. 2013;62:1795–805.
Khouri JM, Bohane TD, Day AS. Is orofacial granulomatosis in children a feature of Crohn’s disease? Acta Paediatr. 2005;94(4):501–4.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this chapter
Cite this chapter
Goyal, A. (2017). The History and Physical Exam. In: Mamula, P., Grossman, A., Baldassano, R., Kelsen, J., Markowitz, J. (eds) Pediatric Inflammatory Bowel Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-49215-5_16
Download citation
DOI: https://doi.org/10.1007/978-3-319-49215-5_16
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-49213-1
Online ISBN: 978-3-319-49215-5
eBook Packages: MedicineMedicine (R0)