Abstract
A thorough history and physical exam are critical in evaluating patients with inflammatory bowel disease (IBD), as it may reveal important information about disease location, activity level, and complications. Abdominal pain, diarrhea, rectal bleeding, and weight loss are common presenting symptoms of IBD, but the presentation may differ between Crohn disease and ulcerative colitis, and even within the two conditions. The history should encompass not only active symptoms, but symptom timeline, prior infectious and medication exposures, diet, and family history. Both patient and parental observations should be reviewed, as patient awareness of symptoms may vary.
A complete physical exam supplements the history to provide a detailed assessment of the patient’s clinical status. The exam should include attention to anthropometrics and nutritional status, oral, abdominal, and perianal examination, extraintestinal manifestations, and for signs of disease activity. Together, a comprehensive history and physical examination form the foundation for initial diagnosis and follow-up care of a child with IBD.
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References
Turner D, et al. Development, validation, and evaluation of a pediatric ulcerative colitis activity index: a prospective multicenter study. Gastroenterology. 2007;133(2):423–32.
Hyams J, et al. Evaluation of the pediatric crohn disease activity index: a prospective multicenter experience. J Pediatr Gastroenterol Nutr. 2005;41(4):416–21.
Fish D, Kugathasan S. Inflammatory bowel disease. Adolesc Med Clin. 2004;15(1):67–90, ix.
Mamula P, Markowitz JE, Baldassano RN. Inflammatory bowel disease in early childhood and adolescence: special considerations. Gastroenterol Clin N Am. 2003;32(3):967–95, viii.
Ishige T. Growth failure in pediatric onset inflammatory bowel disease: mechanisms, epidemiology, and management. Transl Pediatr. 2019;8(1):16–22.
Kugathasan S, et al. Body mass index in children with newly diagnosed inflammatory bowel disease: observations from two multicenter North American inception cohorts. J Pediatr. 2007;151(5):523–7.
Jose FA, et al. Development of extraintestinal manifestations in pediatric patients with inflammatory bowel disease. Inflamm Bowel Dis. 2009;15(1):63–8.
Galbraith SS, et al. Asymptomatic inflammatory bowel disease presenting with mucocutaneous findings. Pediatrics. 2005;116(3):e439–44.
Fielding JF. The relative risk of inflammatory bowel disease among parents and siblings of Crohn's disease patients. J Clin Gastroenterol. 1986;8(6):655–7.
Monsen U, et al. Prevalence of inflammatory bowel disease among relatives of patients with ulcerative colitis. Scand J Gastroenterol. 1987;22(2):214–8.
Motil KJ, et al. Growth failure in children with inflammatory bowel disease: a prospective study. Gastroenterology. 1993;105(3):681–91.
Dotson JL, et al. Extraintestinal manifestations of pediatric inflammatory bowel disease and their relation to disease type and severity. J Pediatr Gastroenterol Nutr. 2010;51(2):140–5.
Alkhouri RH, et al. Vitamin and mineral status in patients with inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2013;56(1):89–92.
Keljo DJ, et al. Course and treatment of perianal disease in children newly diagnosed with Crohn’s disease. Inflamm Bowel Dis. 2009;15(3):383–7.
Greuter T, et al. Extraintestinal manifestations of pediatric inflammatory bowel disease: prevalence, presentation, and anti-TNF treatment. J Pediatr Gastroenterol Nutr. 2017;65(2):200–6.
Naviglio S, et al. Ocular involvement in children with inflammatory bowel disease. Inflamm Bowel Dis. 2017;23(6):986–90.
Lyons JL, Rosenbaum JT. Uveitis associated with inflammatory bowel disease compared with uveitis associated with spondyloarthropathy. Arch Ophthalmol. 1997;115(1):61–4.
Alinaghi F, et al. Global prevalence and bidirectional association between psoriasis and inflammatory bowel disease-a systematic review and meta-analysis. J Crohns Colitis. 2020;14(3):351–60.
Chen WT, Chi CC. Association of hidradenitis suppurativa with inflammatory bowel disease: a systematic review and meta-analysis. JAMA Dermatol. 2019;
Passo MH, Fitzgerald JF, Brandt KD. Arthritis associated with inflammatory bowel disease in children. Relationship of joint disease to activity and severity of bowel lesion. Dig Dis Sci. 1986;31(5):492–7.
Chandrakumar A, et al. Inflammatory bowel disease in children with elevated serum gamma glutamyltransferase levels. J Pediatr. 2019;215:144–151 e3.
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Fusillo, S., Kastl, A.J. (2023). The History and Physical Exam. In: Mamula, P., Kelsen, J.R., Grossman, A.B., Baldassano, R.N., Markowitz, J.E. (eds) Pediatric Inflammatory Bowel Disease. Springer, Cham. https://doi.org/10.1007/978-3-031-14744-9_16
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DOI: https://doi.org/10.1007/978-3-031-14744-9_16
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