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Children and young people with inflammatory bowel disease attend less school than their healthy peers
  1. Claire Barnes1,
  2. James John Ashton1,2,
  3. Florina Borca3,
  4. Mick Cullen1,
  5. Dawn-Marie Walker4,
  6. Robert Mark Beattie1
  1. 1 Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK
  2. 2 Human Genetics and Genomic Medicine, University of Southampton, Southampton, UK
  3. 3 NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
  4. 4 Health Sciences, University of Southampton, Southampton, UK
  1. Correspondence to Dr James John Ashton, Paediatric Medical Unit, University Hospital Southampton, Southampton SO16 6YD, UK; j.ashton{at}


Objective Chronic diseases, such as inflammatory bowel disease (IBD), can impact negatively on education and social development. Examining the impact of IBD on school/college attendance for children and young people (CYP) is vital to provide targeted support to patients, families and schools.

Methods We performed a cross-sectional survey to determine the school/college attendance rates, the reasons for absence related to IBD and facilitators or barriers to school/college attendance. In a subset of patients followed up locally, we performed a detailed review of hospital attendance data to assess healthcare burden.

Results Two hundred and thirty-one questionnaires were given to CYP with IBD aged 5–17 years. Response rate was 74% (final sample 169). The median school/college attendance rate was 92.5%, significantly lower than all children in England (95.2%). 39.6% of children with IBD were persistently absent, defined nationally as missing 10% or more of school. Only five children (3%) had a 100% attendance record. Increasing age and use of monoclonal therapy were predictors of poor school attendance. Concerns about feeling unwell at school/college, access to toilets, keeping up with work and teachers’ understanding of IBD are the main issues for CYP with IBD. There was a significant negative correlation between number of days in hospital and school attendance.

Conclusion IBD has a significant impact on school/college attendance, with hospital attendance, disease burden and school difficulties being major factors. Employing strategies to minimise healthcare burden and developing a partnership between health and education to support children with IBD will serve to facilitate school/college attendance.

  • inflammatory bowel disease
  • school
  • education
  • paediatric
  • chronic illness

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  • Twitter @james__ashton, @RMBeattie50

  • Contributors CB, JJA and RMB conceived the study. The study was designed by CB, JJA, DMW and RMB. Data were collected by CB with help from JJA, FB and MC. Data were analysed by CB and JJA. CB wrote the manuscript with help from all authors. All authors approved the final version prior to submission.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. JJA is funded by an Action Medical Research Clinical fellowship and by a personal ESPEN fellowship.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was registered as a service evaluation following review by UHS Research and Development Department. Ethical approval for the study was obtained from the University of Southampton.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.