Growth in Crohn's disease

Abnormal linear growth is frequent in children and adolescents with Crohn's disease. The typical pattern is of growth retardation associated with dela yed skeletal maturation. Puberty is also frequently delayed. Over 50% of pa tients may have a subnormal height velocity, and approximately 25% will hav e short stature. The endocrine status is characterized by normal growth hor mone secretion and a slightly subnormal serum level of insulin-like growth factor I, which is related to nutritional status. Principal therapeutic opt ions are intestinal resection for localized disease, and enteral nutrition - using a polymeric diet - for more widespread disease, particularly involv ing the small intestine. Growth responses to both modalities are often exce llent and produce considerable psychological benefit. Optimum therapy is ac hieved by close collaboration between gastroenterologists and endocrinologi sts, and by the use of auxological methods to document pre- and post-therap eutic management.