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Title: Endoscopic changes and their histologic evaluation in children with chronic colonic inflammation

Grażyna Mierzwa, Grażyna Bała, Mieczysława Czerwionka-Szaflarska
Contemporary Pediatrics, Gastroenterology, Hepatology and Child Feeding
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chronic inflammatory bowel disease, ulcerative colitis, endoscopy of Iower digestive tract

Introduction: IBD is a group of diseases, with unknown etiology and patogenesis and with increased occurrence. In children the first symptoms appear before 10 years of age, and the different physical, psychological and immunological factors may influence the different clinical course. The aim of the study: The aim of the study was estimation of some epidemiological and clinical data and comparison of endoscopic and histopatholoogical pictures in children with inflammatory bowel disease (IBD) based on our own investigations. Material and methods: From 01.01.1995 till 31.08.1997 164 children were sent to endoscope laboratory of the Department of Pediatrie Allergology and Gastroenterology in order to be diagnosed towards IBD. Indications to endoscopy were analyzed on the basis of most freguently manifested clinical symptoms the chosen epidemiological data (age, sex, social environment) of the sent children. Comparison of endoscope and microscope pictures was carried out as well. Altogether 188 endoscope examinations of Iower digestive tract, including 164 primary examinations and 24 control examinations, were performed in 164 children. 84 of 164 (51.2%) children were girls and 80 (48.8%) were boys. Mean age of the group was 7.5 years. Children from 1st to 6th year of age were examined most often. Among examined children 106 (64.6%) came from municipal and 58 (35.4%) from rural environment. 35 Results: Most frequent clinical symptoms as reasons for endoscope examination were periodical abdominal pains, loose stools, mucous and bloody stools, flatulences and constipations. During endoscope examinations the following results were obtained: chronic nonspecific colitis (56.1%), ulcerative colitis (7.2%), normal mucous membranę of intestine (23.1%). Substantial convergence of morphological and microscopic indicators of nonspecific colitis should be emphasised. Conclusion: Inflammatory bowel disease in children is found already in growing age. Therefore, early endoscope diagnostics of children manifesting clinical symptoms from Iower digestive tract as well as permanent, specialized care are necessary.