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A questionnaire survey of pediatric inflammatory bowel disease in India

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Abstract

Background

Inflammatory bowel disease (IBD) is not uncommon in children and is an important cause of morbidity. Since information on IBD in Indian children is sparse, the study aimed at highlighting the salient features in them.

Materials and Methods

A questionnaire survey was done among 221 children and adolescents with IBD [ulcerative colitis (UC) 93 (42.1 %); Crohn’s disease (CD) 122 (55.2 %); unclassified (IBD-U) 6 (2.7 %)] across seven centers in India. The cut-off age was 18 years and below.

Results

The mean age of presentation for UC and CD was 10.2 ± 4.4 and 11.0 ± 4.5 years, respectively, with no gender difference. Diarrhea (69.9 %, p = 0.001) and blood in the stools (90.3 %, p = 0.0001) were common in UC, whereas abdominal pain (73.8 %, p = 0.01), fever (39.3 %, p = 0.0001), anemia (64.7 %, p = 0.001), and growth failure (76.2 %, p = 0.0001) were common in CD. Extraintestinal manifestations (EIM) were a feature in 23.6 % and 36.1 % of UC and CD, respectively. Pancolitis (E3) was predominant in UC (70.9 %) and 88 % required steroids. Ileocolonic CD (L3) was common in 72.9 %; 76.2 % required azathioprine for maintenance. Of the children with UC, 11.8 % had complications like massive hemorrhage and toxic megacolon, while 27 % of CD had fistulae, perianal abscess, stricture, and perforation. Biologicals were used in 0.8 % of severe UC and in 12.2 % of CD. In UC, 4.3 % required surgical intervention.

Conclusion

Pediatric inflammatory bowel disease (P-IBD) in India shares similarities with adult-onset IBD. Distinctive features were growth failure and more severe forms of the disease necessitating immunomodulators.

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Conflict of interest

MS, SB, SS, NM, MG, NW, MK, and VB declare that they have no conflict of interest.

Ethics statement

The authors declare that the survey was performed in a manner that conforms to the Declaration of Helsinki of 1975, as revised in 2000 and 2008, concerning human and animal rights and that the authors followed the policy concerning informed consent wherever applicable as shown in www.Springer.com.

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Authors and Affiliations

  1. Kanchi Kamakoti Childs Trust Hospital, 12 A, Nageshwara Road, Nungambakkam, Chennai, 600 034, India

    Malathi Sathiyasekaran

  2. Dr Mehta’s Hospital, 2, McNichols Road, 3rd Lane, Chetpet, Chennai, 600 031, India

    Sumathi Bavanandam

  3. Apollo Children’s Hospital, 15, Shafee Mohammed Road, Thousand Lights, Chennai, 600 006, India

    Srinivas Sankaranarayanan

  4. Medanta—The Medicity Hospital, Sector 38, CH Bakhtawar Singh Road, Islampur Colony, Gurgaon, Haryana, 122 001, India

    Neelam Mohan

  5. Department of Gastroenterology, Amrita Institute of Medical Sciences, Peeliyadu Road, Ponekkara, Edappally, Kochi, 682 031, India

    M. Geetha

  6. Institute of Child Health, Sir Ganga Ram Hospital, Old Rajendra Nagar, New Delhi, 110 060, India

    Nishanth Wadhwa & Mohit Kehar

  7. Deenanath Mangeshkar Hospital, B-101, 10a, Parmar Trade Centre, Connaught Road, Sadhu Vaswani Chowk, Pune, 411 001, India

    Vishnu Biradar

Authors
  1. Malathi Sathiyasekaran
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  2. Sumathi Bavanandam
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  3. Srinivas Sankaranarayanan
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  4. Neelam Mohan
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  5. M. Geetha
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  6. Nishanth Wadhwa
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  7. Mohit Kehar
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  8. Vishnu Biradar
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Corresponding author

Correspondence to Malathi Sathiyasekaran.

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Sathiyasekaran, M., Bavanandam, S., Sankaranarayanan, S. et al. A questionnaire survey of pediatric inflammatory bowel disease in India. Indian J Gastroenterol 33, 543–549 (2014). https://doi.org/10.1007/s12664-014-0507-6

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  • DOI: https://doi.org/10.1007/s12664-014-0507-6

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