Assessment of Growth and Nutritional Status in Pediatric Inflammatory Bowel Disease

Abstract

Growth failure and poor nutritional status are common in children with IBD, and can occur before the presentation of other symptoms, particularly among children with Crohn disease [1–5]. Inadequate energy intake can be a major cause of nutrition-related growth failure in children with IBD, but nutrient deficiencies can also contribute to nutrition-related growth failure. Disease severity and treatment regimens, such as glucocorticoid use, also influence growth status. Growth status is a good indicator of overall well-being and nutritional status in children [6], but additional factors, such as genetic potential and timing of sexual maturation also affect growth status. Thus, clinical assessment of growth and nutritional status requires consideration of current and previous growth status, skeletal and sexual maturation, genetic potential for growth, biochemical indicators of micronutrient status, and evaluation of dietary intake. The assessment of growth and nutritional status has two components. The first involves the data acquisition or measurement, such as obtaining height and weight information. The second component is the determination of status, which is the interpretation of the measurement in relation to an appropriate reference. For example, knowing that a child has a height measurement of 145 centimeters has little meaning until height status is determined by comparing the measurement to a growth chart to show that the height is at the 3rd percentile for age and gender. The height status must further be interpreted in light of the genetic and biological potential for growth as assessed by factors such as mid-parental height, ethnicity, skeletal age and sexual maturation.