Peer-reviewed article
Growth impairment in Japanese children with inflammatory bowel disease: A multicenter prospective cohort study.
Shimizu H, Nambu R, Tachibana N, Kunisaki R, Kudo T et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tracked 402 Japanese children with inflammatory bowel disease to understand how often and why growth problems occur. Children diagnosed with ulcerative colitis before age 5 had particularly high rates of growth impairment. Children with Crohn's disease who had growth problems at diagnosis were more likely to recover than those with ulcerative colitis. Prolonged use of corticosteroids was linked to persistent growth problems.
Key points
- At diagnosis, 6.2% of children with ulcerative colitis and 8.3% with Crohn's disease had growth impairment
- Children with ulcerative colitis diagnosed at ages 0-4 years showed much higher growth impairment rates (35.3%)
- Among children with growth impairment at diagnosis, only 9% with ulcerative colitis recovered by 2 years, compared to 50% with Crohn's disease
- New-onset growth impairment occurred in 23% of ulcerative colitis and 16% of Crohn's disease cases; 31% recovered within 2 years
- Prolonged corticosteroid use at 1 year was significantly associated with persistent growth impairment
Limitations
The study describes the pattern and prevalence of growth impairment but does not test a specific intervention to address it. The findings apply to Japanese children and may not generalise to other populations with different treatment practices or genetic backgrounds.
Abstract
Objectives To investigate the prevalence and characteristics of growth impairment (GI) in children with inflammatory bowel disease (IBD). Methods In this prospective observational study, 402 children with ulcerative colitis (UC, n = 257) and Crohn's disease (CD, n = 145) were enrolled from the Japanese Pediatric IBD Registry (2012-2020). GI was defined by Paris classification criteria. Longitudinal outcomes were assessed in children with ≥2 years of follow-up (n = 307). Results At diagnosis, the GI prevalence was comparable between children with UC and CD (6.2% vs. 8.3%, p = 0.54). However, children with UC diagnosed at 0-4 years demonstrated significantly higher GI rates (35.3%) than older children (p < 0.001). All children with CD experiencing GI had small intestinal lesions. Among those with GI at diagnosis, fewer children with UC (9%) recovered growth at a 2-year follow-up than those with CD (50%). Among children with normal growth at baseline, new-onset GI occurred in 23% of UC and 16% of CD cases. Of these, 31% recovered within 2 years, while persistent GI was observed in 16% of UC and 11% of CD cases. Prolonged corticosteroid use at 1 year was more frequent in UC (31% vs. 19%, p = 0.02) and was significantly associated with persistent GI. Conclusions Distinct growth patterns exist in Japanese children with IBD. Children with UC diagnosed at 0-4 years are particularly vulnerable and may benefit from early, steroid-sparing treatment. The association between small intestinal lesions and GI in CD emphasizes the importance of small bowel evaluation. Age-specific, patient-centered growth monitoring is crucial to optimize long-term outcomes.