Ulcerative colitis in children

1
Ulcerative colitis in children
Diagnosis Delay in diagnosis Under-recognized
condition Especially in under 5 Incidence
low but not zero Proctitis constipation with
bleeding Referral system non-existent Diffic
ulty in diagnosis Colonoscopy difficult in 1
year Equipment issues Children refuse to
drink barium!!
2
Ulcerative colitis in children
Disease in children 1. Genetic anticipation 2.
EIM may be the main problem for years Liver
transplant for PSC Arthritis/perianal
abscess 3. Change in disease pattern Proctitis
to left sided or pan-colitis 4. Increased risk
of malignancy
3
Ulcerative colitis in children
Growth and development in children 1. Growth and
development malnutrition, zinc deficiency,
rickets, osteoporosis Short Stature
Disease itself/nutrition/medication Delayed
puberty 2. School days lost Disease
activity Running to bathroom- ridiculed,
Cushingoid Infectivity to others all chronic
disease is HIV!!
4
Ulcerative colitis in children
Treatment of ulcerative colitis in children 1.
Medications Same as in adults Liquid
preparations, granules 2. Steroids - growth
failure/immunosuppression 6 MP -
infections/malignancy 5 ASA 3-5 pancreatitis
rate 3. Effects of long term use of newer
agents? 4. When to stop therapy/surgery in
chronic disease 5. Nutrition
5
Ulcerative colitis in children

• Quality of life
• Poor quality of life
• Multiple hospitalizations and surgeries
• Colectomy and ileostomy
• Psychological problems including depression
• Fish oils
• 2. High cost of chronic illness
• Money, physical and mental cost
• Neglect of other children
• Divorce!