Pediatric Crohn Disease Questions & Answers

Updated: Oct 23, 2018
  • Author: Andrew B Grossman, MD; Chief Editor: Carmen Cuffari, MD  more...
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Questions & Answers

Overview

What is pediatric Crohn disease?

What is the typical presentation of pediatric Crohn disease?

What is the presentation of pediatric Crohn disease of the small intestine?

What is the presentation of pediatric Crohn disease of the colon?

What is the presentation of perianal pediatric Crohn disease?

Which physical findings suggest pediatric Crohn disease?

Which lab test results indicate pediatric Crohn disease?

What is the role of imaging studies in the diagnosis of pediatric Crohn disease?

Which procedures are performed in the diagnosis of pediatric Crohn disease?

What are the goals of treatment for pediatric Crohn disease?

What is the step-up approach for the management of pediatric Crohn disease?

What is the role of surgery in the management of pediatric Crohn disease?

What is pediatric Crohn disease?

What are the effects of pediatric Crohn disease on a child’s development?

What is the pathogenesis of pediatric Crohn disease?

Which endoscopy or colonoscopy findings indicate pediatric Crohn disease?

How is pediatric Crohn disease differentiated from ulcerative colitis (UC)?

What is the etiology of pediatric Crohn disease?

What is the role of genetics in pediatric Crohn disease?

Which genetic mutations are associated with pediatric Crohn disease?

What is the incidence of pediatric Crohn disease in the US?

What is the global prevalence of pediatric Crohn disease?

What percentage of cases of irritable bowel disease (IBD) are pediatric?

Does pediatric Crohn disease have a gender predilection?

Does pediatric Crohn disease have a racial predilection?

What is the prognosis of pediatric Crohn disease?

What information should be provided to parents and children with pediatric Crohn disease?

Presentation

What is the initial evaluation for suspected pediatric Crohn disease?

What are common presenting symptoms of pediatric Crohn disease?

Which factors determine the clinical presentation of pediatric Crohn disease?

What are the signs and symptoms of upper GI pediatric Crohn disease?

What are the signs and symptoms of pediatric Crohn disease of the small intestine?

What are the symptoms of pediatric Crohn disease of the colon?

What are the symptoms of perianal pediatric Crohn disease?

How does pediatric Crohn disease affect growth and development?

Which vital signs findings indicate pediatric Crohn disease?

Which abdominal findings indicate pediatric Crohn disease?

What causes major intestinal complications of pediatric Crohn disease?

What are the symptoms of perforation in pediatric Crohn disease?

What are the possible complications of pediatric Crohn disease and how are they evaluated?

Are patients with pediatric Crohn disease at increased risk for developing GI malignancies?

Which patients with pediatric Crohn disease should undergo a yearly surveillance colonoscopy?

How common are extraintestinal symptoms of pediatric Crohn disease?

What are dermatologic manifestations of pediatric Crohn disease?

What is the prevalence of erythema nodosum in pediatric Crohn disease and how does it present?

What is the presentation of pyoderma gangrenosum in patients with pediatric Crohn disease?

When are aphthous ulcerations likely to appear in patients with pediatric Crohn disease?

What are ophthalmologic manifestations of pediatric Crohn disease?

How common are ophthalmologic complications of pediatric Crohn disease?

Which musculoskeletal disorders are possible complications of pediatric Crohn disease?

What are the symptoms of arthritis in patients with pediatric Crohn disease?

Which bone metabolic disorders are possible complications of pediatric Crohn disease?

What hematologic disorders are possible complications of pediatric Crohn disease?

Which hepatobiliary disorders are possible complications of pediatric Crohn disease?

What is the role of abnormal serum aminotransferases in patients with pediatric Crohn disease?

What is the presentation of liver disease in patients with pediatric Crohn disease?

Which genitourinary disorders are possible complications of pediatric Crohn disease?

What is the prevalence of nephrolithiasis in patients with pediatric Crohn disease?

What causes hydronephrosis in patients with pediatric Crohn disease?

Is pancreatitis a possible complication of pediatric Crohn disease?

Which pulmonary disorders are possible complications of pediatric Crohn disease?

Which cardiovascular disorders are possible complications of pediatric Crohn disease?

What is the prevalence of growth failure in patients with pediatric Crohn disease?

What causes thromboembolic disease in pediatric Crohn disease?

DDX

Which disorders should be included in the differential diagnosis of pediatric Crohn disease?

What are the differential diagnoses for Pediatric Crohn Disease?

Workup

What is the role of a complete blood count (CBC) in the diagnosis of pediatric Crohn disease?

What is the role of routine lab testing in the diagnosis of pediatric Crohn disease?

Which deficiencies in routine lab tests suggest pediatric Crohn disease?

What is the role of stool analysis in the diagnosis of pediatric Crohn disease?

What is the role of serologic testing in the diagnosis of pediatric Crohn disease?

What is the role of enzyme-linked immunosorbent assay (ELISA) in the diagnosis of pediatric Crohn disease?

Which radiological procedure can be used to evaluate the small intestine in patients with pediatric Crohn disease?

What radiological study is performed to evaluate the small bowel in patients with pediatric Crohn disease?

What is the imaging study of choice for the diagnosis of proximal small bowel pediatric Crohn disease?

What is the role of MRI, abdominal ultrasonography (US), and PET scanning in the diagnosis of pediatric Crohn disease?

Which procedure is the diagnostic standard in the diagnosis of pediatric Crohn disease?

What are the roles of upper endoscopy and esophagogastroduodenoscopy (EGD) in the diagnosis of pediatric Crohn disease?

What is the role of video capsule endoscopy in the diagnosis of pediatric Crohn disease?

Which intestinal biopsy findings indicate pediatric Crohn disease?

Which histologic findings may help differentiate ulcerative colitis (UC) from pediatric Crohn disease?

How is disease activity assessed in patients with Crohn disease?

What is the Pediatric Crohn Disease Activity Index (PCDAI)?

Treatment

What are the general goals of treatment for pediatric Crohn disease?

What is the step-up approach to therapy for pediatric Crohn disease?

What is the top-down approach to therapy for pediatric Crohn disease?

Which alternative and complimentary therapies may be beneficial for pediatric Crohn disease?

What is the efficacy of 5-acetylsalicylic acid (5-ASA) in the treatment of pediatric Crohn disease?

What is the efficacy of antibiotics in the treatment of pediatric Crohn disease?

What is the role of nutritional therapy in the management of pediatric Crohn disease treatment?

What is the role of corticosteroids in the management of pediatric Crohn disease?

What is the role of immunomodulators in the management of pediatric Crohn disease treatment?

What is the role of 6-Mercaptopurine (6-MP) and azathioprine in the treatment of pediatric Crohn disease?

What is the efficacy of methotrexate (MTX) in the treatment of pediatric Crohn disease?

When is infliximab (Remicade) indicated in the treatment of pediatric Crohn disease and what are the potential adverse events?

What is the role of adalimumab (Humira) in the treatment of pediatric Crohn disease?

What is the efficacy of adalimumab (Humira) in the treatment of pediatric Crohn disease?

What rare adverse effect has been reported in pediatric patients with Crohn disease receiving treatment with both anti-tumor necrosis factor (TNF)-alpha agents and an immunomodulator?

Are anti-tumor necrosis factor (TNF)-alpha agents more effective than an immunomodulator for the treatment of pediatric Crohn disease?

When is surgery indicated for the management of pediatric Crohn disease?

Is surgical resection a curative treatment for pediatric Crohn disease?

Which specialists should be consulted for the effective treatment of pediatric Crohn disease?

How is intestinal obstruction prevented in patients with pediatric Crohn disease?

What are the uses of nutritional therapy for pediatric Crohn disease?

Which activities should be restricted in patients with pediatric Crohn disease?

What is the long-term follow-up needed for children with Crohn disease?

When is hospitalization indicated in patients with pediatric Crohn disease?

Medications

What are the goals of pharmacotherapy in pediatric Crohn disease?

Which medications in the drug class Antibiotics, Other are used in the treatment of Pediatric Crohn Disease?

Which medications in the drug class Monoclonal Antibodies are used in the treatment of Pediatric Crohn Disease?

Which medications in the drug class Immunosuppressants are used in the treatment of Pediatric Crohn Disease?

Which medications in the drug class Corticosteroids are used in the treatment of Pediatric Crohn Disease?

Which medications in the drug class 5-Aminosalicylic Acid Derivatives are used in the treatment of Pediatric Crohn Disease?