CROHNS-DISEASE IN CHILDREN 10 YEARS OLD AND YOUNGER - COMPARISON WITHULCERATIVE-COLITIS

In order to examine the presentation and course of Crohn's disease (CD ) versus those of ulcerative colitis (UC) in children less than or equ al to 10 years of age, a retrospective review of children less than or equal to 10 years old with inflammatory bowel disease singled out 40 patients and compared their findings with those of 38 children with UC . The mean age at onset was 7.5 years for CD, as compared with 5.9 yea rs for UC. A family history of inflammatory bowel disease was present in 13 patients (32%). Abdominal pain (97%), diarrhea (78%), and weight loss (88%) were the major initial complaints, with growth retardation present in 12 (30%) children. At onset, four children had diffuse sma ll-bowel disease, nine had terminal deal disease, 15 had ileocolitis, and 12 had colitis; at the end of the study two had diffuse small-bowe r disease, four had terminal heal disease, 25 had ileocolitis, and sev en had colitis. Extraintestinal manifestations increased with duration of disease. Although the number of recurrences did not differ greatly between groups, those with ileocolitis and colitis needed longer ster oid therapy and more days in hospital than did those with only small-b owel disease. Operation was required in 42.5% of children with CD, as compared with 5% of those with UC, with six CD children (35%) requirin g later reoperation for recurrent disease or fistula and abscess. Two children died from causes unrelated to their disease (gastric volvulus , carcinoma of the breast). The number of operations, duration of ster oid therapy in the course of a year, and days in hospital for children with CD exceeded those for a similar group of children with UC. The q uality of life noted at the end of the study period was considered onl y fair in the majority (70%) of CD patients, in contrast to those with UC, 75% of whom considered life good after 2 years of illness.