Frequency and clinical significance of histologic upper gastrointestinal tract findings in children with inflammatory bowel disease

Figures & data

Table 1. Baseline characteristics in children with UC, CD and in control children with no diagnoses in gastrointestinal endoscopies

	UC	CD	Controls
	n = 76	n = 47	n = 162
	%	%	%	p-value
Demographic data
Age				<0.001
<7 years	13.2	14.9	33.3
7–12 years	27.6	31.9	35.8
>12 years	59.2	53.2	30.9
Girls	40.8	46.8	46.9	0.658
IBD in relatives	18.4	14.9	16.7	0.875
Autoimmunity^a	9.2	2.1	6.2	0.290
Asthma/allergy	15.8	29.8	24.7	0.158
Other chronic disease^b	11.8	6.4	10.5	0.610
Laboratory values
Anemia	63.5	45.7	12.8	<0.001
Hypersedimentation	65.3	60.5	17.5	<0.001
Elevated fecal calprotectin	92.2	79.4	25.9	<0.001
Hypoalbuminemia	42.0	38.5	12.9	<0.001
Symptoms
Abdominal pain	61.8	70.2	80.9	0.006
Diarrhea	59.2	44.7	49.4	0.227
Bloody diarrhea	63.2	23.4	10.5	<0.001
Constipation	7.9	12.8	16.7	0.182
Vomiting	6.6	10.6	8.6	0.725
Failure to thrive	28.9	48.9	17.9	<0.001
Heartburn	2.6	0	8.0	0.046
Other^c	73.7	76.6	67.9	0.421

^aExample: celiac disease, type 1 diabetes and juvenile arthritis.

^bExample: migraine, attention deficit hyperactivity disorder and epilepsy.

^cExample: fever, joint pain, fatigue and nausea.

ESR: erythrocyte sedimentation rate; IBD: inflammatory bowel disease.

Data was available in >88% of cases for each variable except calprotectin from 69% and Alb from 62%. Values in bold face represent significant findings.

Figure 1. Histological UGI findings in 47 children with CD, 76 children with UC and 162 control children who underwent upper and lower gastrointestinal endoscopies but were not diagnosed with any organic condition.

Table 2. Relationships between clinical features and presence of histologic UGI findings in 132 children with IBD.^a

		UGI findings
	Total cases	N	%	OR^b	95% CI
Demographic data
Age <7 years	19	10	52.6	1	–
Age 7–12 years	42	29	69.0	0.50	0.16–1.52
Age >12 years	71	53	74.6	0.38	0.13–1.08
Boys	74	49	66.2	1	–
Girls	58	43	74.1	1.46	0.68–3.13
IBD in relatives	23	14	60.9	0.62	0.24–1.58
Co-existing autoimmunity^c	8	6	75.0	1.33	0.26–6.87
Asthma/allergy	27	21	77.8	1.68	0.62–4.53
Other chronic disease^d	13	10	77.0	1.50	0.39–5.79
Laboratory values
Anemia	74	55	74.3	1.65	0.78–3.52
Hypersedimentation	80	56	70.0	1.13	0.51–2.50
Elevated fecal calprotectin	80	56	70.0	1.33	0.36–4.98
Hypoalbuminemia	36	29	80.6	3.22	1.18–8.79
Symptoms
Abdominal pain	86	60	69.8	1.01	0.46–2.20
Diarrhea	69	52	75.4	1.76	0.83–3.72
Bloody diarrhea	63	43	68.3	0.88	0.42–1.85
Vomiting	10	9	90.0	4.23	0.52–34.56
Failure to thrive	46	38	82.6	2.82	1.17–6.78
Other^e	99	92	92.9	0.67	0.27–1.65

^aIncludes patients with CD, UC or IBD unclassified.

^bBinary logistic regression analysis.

^cExample: celiac disease, type 1 diabetes and juvenile arthritis.

^dExample: migraine, attention deficit hyperactivity disorder and epilepsy.

^eExample: fever, joint pain, fatigue and nausea.

CI: confidence interval; ESR: erythrocyte sedimentation rate; OR: odds ratio.

Data was available in >90% of cases for each variable except calprotectin in 69% and low Alb in 64%. Values in bold face represent significant findings.

Table 3. Presence of complications and co-morbidities in 123 children with CD or UC with and without UGI findings

	UGI	No UGI	p-value
	%	%
CD, n = 47
Overall	26.3	55.6	0.091
Perianal fistulas, fissures or skin tags	13.2	44.4	0.032
Abscesses, fistulas, strictures or  disease-related surgery	7.9	22.2	0.210
Co-morbidity^a	5.3	0.0	0.482
UC, n = 76
Overall	25.0	7.1	0.053
Perianal fissures	6.3	3.6	0.614
Abscesses, colonic strictures or  disease-related surgery	4.2	0.0	0.274
Co-morbidity^a	18.8	3.6	0.059

^aExample: autoimmune hepatitis, primary sclerosing cholangitis, uveitis, pancreatitis, ankylosing, spondylitis or peripheral arthritis, pyoderma gangrenosum, thrombosis and gastrointestinal malignancy.

Values in bold face represent significant findings.