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Paediatric inflammatory bowel disease: improving early diagnosis
  1. James John Ashton1,2,
  2. Anthony Harden3,
  3. R Mark Beattie1
  1. 1Department of Paediatric Gastroenterology, Southampton Children’s Hospital, Southampton, UK
  2. 2Department of Human Genetics and Genomics, University of Southampton, Southampton, UK
  3. 3Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
  1. Correspondence to Professor R Mark Beattie, Department of Paediatric Gastroenterology, Southampton Children’s Hospital, Southampton SO16 6YD, UK; rm.beattie{at}btinternet.com

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For many conditions, delayed diagnosis results in worse outcomes, increased mortality and amplified disease burden. In children, an emphasis on rapid, accurate diagnosis in leukaemia, lymphoma and solid tumours has been associated with an increasing survival rate and reduced morbidity over the last 25 years. The challenge is to extend early diagnosis to chronic conditions in children where early intervention will improve long-term outcomes. Similarly in adult patients, rapid access clinics for specific conditions are now routine, enabling quick referral to the specialist care service to make the precise diagnosis and start the correct treatment.

In their paper, Riccuito et al reported diagnostic delay and subsequent impact on outcome in Canadian children with inflammatory bowel disease (IBD).1

IBD, consisting of Crohn’s disease, ulcerative colitis and IBD unclassified, is a chronic, heterogeneous, relapsing and remitting condition primarily as a consequence of inflammation within the bowel lumen. Early and effective treatment is crucial to control symptoms, minimise impact on nutrition and growth and enable the child to function well (eg, attend school). Over the last 20 years, there has been a steady increase in the incidence of paedaitric inflammatory bowel disease (PIBD), with a consequent increase in children presenting to primary, secondary and tertiary care.2 Paediatric gastroenterologists have been concerned for over 25 years that diagnostic delay is common. This delay is clearly multifactorial, and to determine how best to effect change would require an analysis of all aspects of the patient pathway.

Riccuito …

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