Long-term health outcomes in pediatric inflammatory bowel disease: a population-based study.

BACKGROUND

The long-term sequelae of inflammatory bowel disease (IBD) may differ between children and adults. We evaluated the health status of patients with pediatric onset of IBD and controls in early adulthood.

METHODS

A questionnaire on the current health status and disease history was mailed to patients with childhood onset IBD diagnosed during 1987-2003 in 2 university hospitals in Finland. Matched controls were randomly selected from the Population Register Centre.

RESULTS

A total of 368 (67%) of the 550 patients and 646 (37%) controls responded (median age 20 years). Ulcerative colitis (UC) was the most common primary diagnosis (58%) reclassified as Crohn's disease (CD) in 8.5%. Of the patients, 80% had been on glucocorticoids at some point (median duration of the disease 8.3 years). One-third of CD patients had undergone intestinal resection. In UC, total colectomy was common (24%). The frequency of joint diseases (5.4% versus 0.2%) and biliary duct diseases (2.7% versus 0.3%) was higher in patients than in controls (P < 0.001). Overall quality of life was decreased in the patients (mean score 5.7 versus 6.0 in controls, P < 0.001). Further, some impediment on adult height and weight was observed among male patients.

CONCLUSIONS

IBD in children may have a more aggressive disease course than in adults, since most pediatric patients need glucocorticoids, and abdominal surgery is frequent. At 8 years from diagnosis, most patients have active disease and quality of life is slightly lower than in the rest of the population.