CROHNS DISEASE IN CHILDREN

CROHNS DISEASE IN CHILDREN

A 5-year-old boy came to us with history of chronic diarrhea for last one year. Diarrhea was small bowel type. There was associated anemia, zinc deficiency (acrodermatitis enteropathica) and failure to thrive. His appetite was moderate. He had received anti tubercular therapy for pulmonary lesion 2 years back. Presently there were no respiratory symptoms. A strong possibility of inflammatory bowel disease was kept. His colonoscopy revealed typical ulcers of Crohns Disease and biopsy was also suggestive of the same. Upper GI endoscopy revealed linear long esophageal ulcers.

Crohn’s disease (CD) is a chronic digestive disorder that belongs to a group of condition called Inflammatory Bowel Diseases (IBD) and is characterized by inflammation and damage in the digestive tract. CD is characterized by a transmural and often granulomatousinflammation that can involve any part of the gastrointestinal tract from lips to anus. It is often diagnosed in late childhood and early adulthood, but can also occur invery young children.It is thought to be the result of an altered immune responseto commensal bacteria in a genetically susceptible host.

Common symptoms of CD are abdominal pain, diarrhea, anemia, blood in stools, tenesmus, mild feverand weight loss. Many children present with non-specific symptoms such aslethargy, nausea and anorexia, which may be associated with only mild abdominal discomfort.The symptoms can vary significantly from patient to patient and do not have to be the same in every child. Unique to childhood CD is the occurrence of growth impairment and pubertaldelay. Growth impairment may be the first sign of CD, and may start several yearsbefore the onset of gastrointestinal