Chronic IBD in Children in Central and Western Slovenia

Abstract

Background: Data on the epidemiology of chronic inflammatory bowel disease in children in Slovenia is sparse. We evaluated the incidence, clinical and demographic features of pediatric inflammatory bowel disease (IBD) occurring in central and western Slovenia over the past 12 years. Methods: At the University Children's Hospital of Ljubljana we retrospectively collected data for all children with suspected IBD treated in the area of central and western Slovenia (7 pediatric and gastroenterology centers) in the 12-year period 1994-2005 using patient charts. IBD diagnosis was based on clinical presentation, endoscopy and histology results, disease activity was evaluated with PCDAI and UCAI. Results: The mean annual incidence of total pediatric IBD in central and western Slovenia was 4.03, the mean annual incidence of Crohn's disease (CD), ulcerative colitis (UC) and indeterminate colitis (IC) was 2.42, 1.14 and 0.47, respectively. In the last six-year period the incidence of total IBD rose almost 1.7-fold.TABLE 1: Mean and minimal age at presentation and mean duration of symptoms before disease diagnosisTABLE 2: Presentation of Crohn's disease (n = 82)TABLE 3: Extent of ulcerose colitis (n = 39)Disease severity was assessed using PCDAI and UCAI scoring systems. Of 82 children with newly diagnosed CD 39 (47%) had severe disease at its onset (PCDAI more than 30). Severe form of UC was present in 3 (8%) of total 39 patients with UC at its onset (UCAI more than 16). Conclusions: Incidence of total pediatric IBD in central and western Slovenia is high and seems to be still rising. Crohn's disease is the most prevalent form of IBD with incidence comparable to other central and western European countries. The incidence of UC and IC is rising more rapidly than the incidence of CD. CD is most commonly presented with inflammatory form of disease, almost half of the patients have severe form of CD at its onset. Pancolitis is the most frequent form of UC.