Pediatric inflammatory bowel diseases: Effects of disease and treatment regimens on growth and puberty.

Abstract

Objective: Inflammatory bowel diseases (IBD) are lifelong conditions that exhibit periods of remission and exacerbation. In addition to gastrointestinal manifestations, they can also cause growth retardation and disorders of puberty in children. The objective of this study was to evaluate the effects of the disease and the treatment regimens on growth and puberty in children and adolescents with IBD.

Methods: A retrospective screening of patients aged 2 to 18 years with a minimum of six months of follow-up due to inflammatory bowel disease (IBD) between January 2016 and April 2022 was conducted. The growth parameters were compared between disease groups, gender groups, disease activity and level of inflammation groups, and treatment regimen groups. The effects of treatment protocols on growth were evaluated by comparing the data before and after treatment, and the pubertal status of patients was evaluated by comparing them with healthy children.

Results: A total of 58 patients were evaluated, comprising 29 individuals with Crohn's Disease (CD) and 29 with ulcerative colitis (UC). The growth and pubertal development of patients at the time of diagnosis did not differ based on gender or the specific disease type. A negative deviation from the target height was observed to be more prevalent in patients with Crohn's disease. Following treatment, patients exhibited a significant improvement in weight and BMI SDS, although no significant change in height SDS was observed. In comparison to healthy Turkish children, the patients exhibited a delayed pubertal progression, despite the normal onset of puberty.

Conclusion: Children and adolescents with IBD exhibited no significant adverse effects on linear growth at diagnosis or during the follow-up period, regardless of the primary disease and the treatment protocols. This was likely due to their timely diagnosis and successful treatment. It is important to monitor puberty, as it may progress more slowly or even cease in these patients compared to healthy children.