Complications of pediatric inflammatory bowel diseases include:
(1) impaired linear growth
(2) delayed puberty
A reduction in height velocity may be an early indicator of the disease.
Factors that may explain these findings:
(1) malnutrition secondary to the bowel involvement and/or anorexia
(2) chronic inflammation with an increase in circulating levels of cytokines
(3) decreased levels of insulin-like growth factor I (IGF-I)
(4) high doses of corticosteroids
Management may include:
(1) optimize nutrition, often with enteral nutrition
(2) decrease disease activity and inflammation (with infliximab or other therapy, using steroid-sparing agents when possible)
(3) consider surgery if it could induce a remission or otherwise benefit the patient
Effective management often requires close cooperation between a variety of clinicians and specialists.
Early institution of effective therapy can minimize any developmental impairment.
Close monitoring of height and progression of puberty can be used as outcome measures of therapeutic effectiveness.
