Ulcerative colitis and Crohn's disease may present before the age of 20 years in 25% to 30% of all patients with inflammatory bowel disease (IBD).
Reported incidence figures vary considerably depending on the collection of data.
Multicenter, multinational collaboration is needed when studying pediatric inflammatory bowel disease.
|The program includes colonoscopy with ileal intubation, and upper gastrointestinal endoscopy|
|Journal of Pediatric Gastroenterology & Nutrition|
The essential first step is uniformity in the work-up and criteria used for diagnosis.
The IBD Working Group of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition, or ESPGHAN, present the Porto diagnostic criteria to provide the tool that is needed.
These criteria are the result of consensus reached by the ESPGHAN inflammatory bowel disease working group.
Diagnosis of Crohn disease, ulcerative colitis and indeterminate colitis is based on clinical signs and symptoms, endoscopy and histology and radiology.
The working group recommends that every child suspected of IBD should undergo a complete diagnostic program.
The program consists of colonoscopy with ileal intubation, upper gastrointestinal endoscopy, and radiologic contrast imaging of the small bowel in all cases except in definite ulcerative colitis.
The working group suggests that multiple biopsies from all segments of the gastrointestinal tract are needed for a complete histologic evaluation.
The IBD Working Group of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition conclude, “A diagnosis of indeterminate colitis cannot be made unless a full diagnostic program has been performed.”