Retrospective evaluation of the cases followed with the diagnosis of inflammatory bowel disease

Inflammatory bowel disease (IBD); It is a chronic inflammatory disorder of the gastrointestinal tract of unknown etiopathogenesis. The incidence of IBD in children is increasing. In this study, it was aimed to evaluate the complaints of patients diagnosed with IBD at admission, physical examination and laboratory findings at admission, imaging methods used for diagnosis, endoscopy and pathology results, and planned treatments. In this study, the data of children and adolescents diagnosed with IBD in Fırat University Hospital, Department of Pediatric Gastroenterology Hepatology an Nutrition between 2005 and 2021 were analyzed retrospectively. The data of the cases were obtained from patient files and hospital automation system records. 138 cases diagnosed and followed up in our hospital were included in the study. The patients' diagnosis, gender, age, complaint at presentation, consanguinity between parents, family history of IBD, physical examination findings including anthropometric measurements at the time of admission, laboratory findings, genetic analysis, radiological imaging, endoscopy and histopathological findings, and treatments received were examined. The analyzes were evaluated using SPSS (Statistical Package for Social Sciences) 22 package programs and the statistical significance level was accepted as p<0.05. In our study, 138 cases, 46 of whom were diagnosed with Crohn's disease (CD), 86 with ulcerative colitis (UC), and 6 with indeterminate colitis, were evaluated. Of the cases, 68 were girls and 70 were boys, with a mean age of 11.1±4.4 years. The rate of complaints of bloody stool in ulcerative colitis cases was found to be significantly higher than in Crohn's cases (p<0.001). The rate of complaints of joint pain in Crohn's cases was slightly higher than in UC cases (p=0.05). Familial Mediterranean fever was the most common comorbid disease and the presence of comorbidity was found to be significantly higher in Crohn's cases (p=0.01). While normal physical examination findings were observed in 63.8% of the cases, the incidence of anal fistula was found to be significantly higher in Crohn's cases than in UC cases (p=0.041). It was observed that leukocyte (p=0.044), ferritin (p=0.005) and CRP (p<0.001) values were higher in Crohn cases than UC cases. Colon wall thickening was the most common pathological finding in ultrasonography (USG), computed tomography (CT) and magnetic resonance imaging (MRI). The mean BMD SDS value of the patients whose bone mineral density (BMD) could be evaluated was -0.6±1.3. Osteoporosis was found in 13.6% of the evaluated patients, and osteopenia was found in 20.5%. Both osteoporosis and osteopenia were more common in Crohn's patients. Colon involvement was most common in CD. In UC, involvement in the form of pancolitis was most common, and pancolitis cases were found to have a higher PUCAI (Pediatric Ulcerative Colitis Activity Index). The most common treatment was mesalazine and steroid use. In conclusion, inflammatory bowel disease should be considered in cases presenting with abdominal pain, bloody stools and diarrhea. Although the incidence of Crohn's disease is higher in children in many parts of the world, ulcerative colitis was found to be more common both in our study and in other studies in our country. Larger studies are needed to determine the true incidence and prevalence of inflammatory bowel disease in children in our country. Keywords: Inflammatory bowel disease, Child, Crohn's Disease, Ulcerative colitis.