Inflammatory bowel disease in children, an evolving problem in Kuwait

Wafa'a A Al-Qabandi 1, Eman K Buhamrah, Khaled A Hamadi, Suad A Al-Osaimi, Ahlam A Al-Ruwayeh, JohnPatrick Madda

Affiliations

01 September 2011

-

doi: 10.4103/1319-3767.84487

Abstract

Background/aims: Inflammatory bowel disease (IBD) was previously thought a rare disease among children in Kuwait since most diarrhea cases were attributed to infections. In the past few years we observed an increase in the number of patients presenting with IBD. In this study we aimed to determine the epidemiology of IBD among children in the State of Kuwait.

Patients and methods: The charts of all children with IBD who were referred to the pediatric gastroenterology unit during the period February 1998 to January 2008 were retrospectively reviewed.

Results: Out of a total of 130 children with IBD, 92 (71%) had Crohn's disease, 36 (28%) had ulcerative colitis and two (1%) had indeterminate colitis. The estimated annual incidence for IBD was 2.16/10 5 /year. The age range was nine months-15 years (median: 11 years). Fifty-three percent of all patients were females and 77% were Kuwaiti nationals. Positive family history was found in 23%. The commonest presenting symptoms were abdominal pain (87%) and diarrhea (82%). Failure to thrive was detected in 35% and short stature in 20% at presentation. The ileocolonic region was the most common presentation site affected in Crohn's patients and pancolitis was the commonest in ulcerative colitis.

Conclusion: Inflammatory bowel disease is not uncommon in our children. We found no differences regarding disease presentation and clinical features compared to the Western world.

Conflict of interest statement

Conflict of Interest: None declared.

Similar articles

Characteristics and trends in the incidence of inflammatory bowel disease in Korean children: a single-center experience.

Kim BJ, Song SM, Kim KM, Lee YJ, Rhee KW, Jang JY, Park SJ, Yoon CH.Dig Dis Sci. 2010 Jul;55(7):1989-95. doi: 10.1007/s10620-009-0963-5. Epub 2009 Sep 10.PMID: 19763825

Findings of colonoscopy in children: experience from Kuwait.

Kalaoui M, Radhakrishnan S, al Shamali M, Hasan F, al-Nakib B.J Trop Pediatr. 1998 Dec;44(6):371-5. doi: 10.1093/tropej/44.6.371.PMID: 9972085

Very-early-onset inflammatory bowel disease versus late-onset inflammatory bowel disease in relation to clinical phenotype: A cross-sectional study.

Mansour HH, Seddek SS, Meguid MEAEL, Eskander AE, Galal ST.Indian J Gastroenterol. 2023 Apr;42(2):185-191. doi: 10.1007/s12664-022-01318-4. Epub 2023 May 11.PMID: 37166697

Indeterminate colitis: a distinctive clinical pattern of inflammatory bowel disease in children.

Romano C, Famiani A, Gallizzi R, Comito D, Ferrau' V, Rossi P.Pediatrics. 2008 Dec;122(6):e1278-81. doi: 10.1542/peds.2008-2306.PMID: 19047226 Review.

Differentiating ulcerative colitis from Crohn disease in children and young adults: report of a working group of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the Crohn's and Colitis Foundation of America.

North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition; Colitis Foundation of America; Bousvaros A, Antonioli DA, Colletti RB, Dubinsky MC, Glickman JN, Gold BD, Griffiths AM, Jevon GP, Higuchi LM, Hyams JS, Kirschner BS, Kugathasan S, Baldassano RN, Russo PA.J Pediatr Gastroenterol Nutr. 2007 May;44(5):653-74. doi: 10.1097/MPG.0b013e31805563f3.PMID: 17460505

Cited by

Incidence, Prevalence, and Clinical Epidemiology of Inflammatory Bowel Disease in the Arab World: A Systematic Review and Meta-Analysis.

Mosli M, Alawadhi S, Hasan F, Abou Rached A, Sanai F, Danese S.Inflamm Intest Dis. 2021 Sep 7;6(3):123-131. doi: 10.1159/000518003. eCollection 2021 Sep.PMID: 34722642 Free PMC article. Review.

Inflammatory bowel disease: An Indian perspective.

Jain M, Venkataraman J.Indian J Med Res. 2021 Apr;153(4):421-430. doi: 10.4103/ijmr.IJMR_936_18.PMID: 34380788 Free PMC article. Review.

Pediatric inflammatory bowel disease: Is it really uncommon in Asian children?

Poddar U, Yachha SK, Srivastava A, Kumari N.JGH Open. 2020 Apr 26;4(5):860-866. doi: 10.1002/jgh3.12330. eCollection 2020 Oct.PMID: 33102756 Free PMC article.

Regional variation of pediatric inflammatory bowel disease in Saudi Arabia: Results from a multicenter study.

El Mouzan MI, AlEdreesi MH, Hasosah MY, Al-Hussaini AA, Al Sarkhy AA, Assiri AA.World J Gastroenterol. 2020 Jan 28;26(4):416-423. doi: 10.3748/wjg.v26.i4.416.PMID: 32063690 Free PMC article.

Knowledge and attitudes of primary healthcare physicians toward the diagnosis and management of inflammatory bowel disease following an educational intervention: A comparative analysis.

Alharbi R, Almahmudi F, Makhdoom Y, Mosli M.Saudi J Gastroenterol. 2019 Sep-Oct;25(5):277-285. doi: 10.4103/sjg.SJG_169_19.PMID: 31187783 Free PMC article.

KMEL References

https://pubmed.ncbi.nlm.nih.gov/

References

  1.  
    1. Armitage E, Drummond HE, Wilson DC, Ghosh S. Increasing incidence of both juvenile-onset Crohn's disease and ulcerative colitis in Scotland. Eur J Gastroenterol Hepatol. 2001;13:1439–47. - PubMed
  2.  
    1. Hildebrand H, Finkel Y, Grahnquist L, Lindholm J, Ekbom A, Askling J. Changing pattern of paediatric inflammatory bowel disease in northern Stockholm 1990-2001. Gut. 2003;52:1432–4. - PMC - PubMed
  3.  
    1. Kugathasan S, Judd RH, Hoffman RG, Heikenen J, Telega G, Khan F, et al. Epidemiologic and clinical characteristics of children with newly diagnosed inflammatory bowel disease in Wisconsin: A statewide population-based study. J Pediatr. 2003;143:525–31. - PubMed
  4.  
    1. Phavichitr N, Cameron DJ, Catto-Smith AG. Increasing incidence of Crohn's disease in Victorian children. J Gastroenterol Hepatol. 2003;18:329–32. - PubMed
  5.  
    1. Ouyang Q, Tandon R, Goh KL, Ogata H, Fiocchi C. The emergence of inflammatory bowel disease in the Asian Pacific region. Cur Op Gastroenterol. 2005;21:408. - PubMed
  6.  
    1. Thia KT, Loftus EV, Sandborn WJ, Yang SK. An update on the epidemiology of inflammatory bowel disease in Asia. Am J Gastroenterol. 2008;103:3167–82. - PubMed
  7.  
    1. IBD working group of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). Inflammatory bowel disease in children and adolescents: Recommendations for diagnosis- the Porto criteria. J Pediatr Gastroenterol Nutr. 2005;41:1–7. - PubMed
  8.  
    1. Bousvaros A, Antonioli DA, Colletti RB, Dubinsky MC, Glickman JN, Gold BD, et al. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition; Colitis Foundation of America. Differentiating ulcerative colitis from Crohn disease in children and young adults: Report of a working group of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the Crohn's and Colitis Foundation of America. J Pediatr Gastroenterol Nutr. 2007;44:653–74. - PubMed
  9.  
    1. Aghazadeh R, Zali MR, Bahari A, Amin K, Ghahghaie F, Firouzi F. Inflammatory bowel disease in Iran: A review of 457 cases. J Gastroenterol Hepatol. 2005;20:1691–5. - PubMed
  10.  
    1. Radhakrishnan S, Zubaidi G, Daniel M, Sachdev GK, Mohan AN. Ulcerative colitis in Oman.A prospective study of the incidence and disease pattern from 1987 to 1994. Digestion. 1997;58:266–70. - PubMed
  11.  
    1. Al-Ghamdi AS, Al-Mofleh IA, Al-Rashed RS, Al-Amri SM, Aljebreen AM, Isnani AC, et al. Epidemiology and outcome of Crohn's disease in a teaching hospital in Riyadh. World J Gastroenterol. 2004;10:1341–4. - PMC - PubMed
  12.  
    1. Khawaja AQ, Sawan AS. Inflammatory bowel disease in the Western Saudi Arabia. Saudi Med J. 2009;30:537–40. - PubMed
  13.  
    1. Butt MT, Bener A, Al-Kaabi S, Yakoub R. Clinical characteristics of Crohn's disease in Qatar. Saudi Med J. 2005;26:1796–9. - PubMed
  14.  
    1. Al-Nakib B, Radhakrishnan S, Jacob GS, Al-Liddawi H, Al-Ruwaih A. Inflammatory bowel disease in Kuwait. Am J Gastroenterol. 1984;79:191–4. - PubMed
  15.  
    1. Al-Shamali MA, Kalaoui M, Patty I, Hasan F, Khajah A, Al-Nakib B. Ulcerative colitis in Kuwait: A review of 90 cases. Digestion. 2003;67:218–24. - PubMed
  16.  
    1. Toonisi TS. Crohn's disease in children from the western region of Saudi Arabia. J Gastroenterol Hepatol. 1993;8:462–4. - PubMed
  17.  
    1. Kalaoui M, Radhakrishnan S, Al Shamali M, Hasan F, Al-Nakib B. Findings of colonoscopy in children: Experience from Kuwait. J Trop Pediatr. 1998;44:371–5. - PubMed
  18.  
    1. El Mouzan MI, Abdullah AM, Al Habbal MT. Epidemiology of juvenile-onset inflammatory bowel disease in central Saudi Arabia. J Trop Pediatr. 2006;52:69–71. - PubMed
  19.  
    1. Heyman MB, Kirschner BS, Gold BD, Ferry G, Baldassano R, Cohen SA, et al. Children with early-onset inflammatory bowel disease (IBD): Analysis of a pediatric IBD consortium registry. J Pediatr. 2005;146:35–40. - PubMed
  20.  
    1. Grieci T, Butter A. The incidence of inflammatory bowel disease in the pediatric population of Southwestern Ontario. J Pediatr Surg. 2009;44:977–80. - PubMed
  21.  
    1. Perminow G, Brackmann S, Lvckander LG, Franke A, Borthne A, Rydning A, et al. A characterization in childhood inflammatory bowel disease, a new population-based inception cohort from South-Eastern Norway, 2005-07, showing increased incidence in Crohn's disease. Scand J Gastroenterol. 2009;44:446–56. - PubMed
  22.  
    1. Sawczenko A, Sandhu BK, Logan RF, Jenkins H, Taylor CJ, Mian S, et al. Prospective survey of childhood inflammatory bowel disease in the British Isles. Lancet. 2001;357:1093–4. - PubMed
  23.  
    1. Armitage EL, Aldhous MC, Anderson N, Drummond HE, Riemersma RA, Ghosh S, et al. Incidence of juvenile-onset Crohn's disease in Scotland: Association with Northern latitude and affluence. Gastroenterology. 2004;127:1051–7. - PubMed
  24.  
    1. Auvin S, Molinie F, Gower-Rousseau C, Brazier F, Merle V, Grandbastien B, et al. Incidence, clinical presentation and location at diagnosis of pediatric inflammatory bowel disease: A prospective population-based study in northern France (1988-1999) J Pediatr Gastroenterol Nutr. 2005;41:49–55. - PubMed
  25.  
    1. Castro M, Papadatou B, Baldassare M, Balli F, Barabino A, Barbera C, et al. Inflammatory bowel disease in children and adolescents in Italy: Data from the pediatric national IBD register (1996-2003) Inflamm Bowel Dis. 2008;14:1246–52. - PubMed
  26.  
    1. Carvalho RS, Abadom V, Dilworth HP, Thompson R, Oliva-Hemker M, Cuffari C. Indeterminate colitis: A significant subgroup of pediatric IBD. Inflamm Bowel Dis. 2006;12:258–62. - PubMed
  27.  
    1. Weinstein TA, Levine M, Pettei MJ, Gold DM, Kessler BH, Levine JJ. Age and family history at presentation of pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2003;37:609–13. - PubMed
  28.  
    1. Sawczenko A, Sandhu BK. Presenting features of inflammatory bowel disease in Great Britain and Ireland. Arch Dis Child. 2003;88:995–1000. - PMC - PubMed
  29.  
    1. Motil KJ, Grand RJ, Davis-Kraft L, Ferlic LL, Smith EO. Growth failure in children with inflammatory bowel disease: A prospective study. Gastroenterology. 1993;105:681–91. - PubMed
  30.  
    1. Keljo DJ, Markowitz J, Langton C, Lerer T, Bousvaros A, Carvalho R, et al. Course and treatment of perianal disease in children newly diagnosed with Crohn's disease. Inflamm Bowel Dis. 2009;15:383–7. - PubMed
  31.  
    1. Cabrera-Abreu JC, Davies P, Matek Z, Murphy MS. Performance of blood tests in diagnosis of inflammatory bowel disease in a specialist clinic. Arch Dis Child. 2004;89:69–71. - PMC - PubMed
  32.  
    1. Van Limbergen J, Russell RK, Drummond HE, Aldhous MC, Round NK, Nimmo ER, et al. Definition of phenotypic characteristics of childhood-onset inflammatory bowel disease. Gastroenterolgy. 2008;135:1114–22. - PubMed
  33.  
    1. Castellaneta SP, Afzal NA, Greenberg M, Deere H, Davies S, Murch SH, et al. Diagnostic role of upper gastrointestinal endoscopy in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2004;39:257–61. - PubMed
  34.  
    1. Levine JB, Lukawski-Trubish D. Extraintestinal considerations in inflammatory bowel disease. Gastroenterol Clin North Am. 1995;24:633–46. - PubMed
  35.  
    1. Standridge S, de los Reyes E. Inflammatory bowel disease and cerebrovascular arterial and venous thromboembolic events in 4 pediatric patients: A case series and review of the literature. J Child Neurol. 2008;23:59–66. - PubMed
  36.  
    1. Harewood GC, Loftus EV, Tefferi A, Tremaine WJ, Sandborn WJ. Concurrent inflammatory bowel disease and myelodysplastic syndromes. Inflamm Bowel Dis. 1999;5:98–103. - PubMed

Page Navigation