Review
Chronic inflammatory bowel disease in children: a complex problem in management
J A Walker-Smith
University
Department of Paediatric Gastroenterology, Royal Free and University
College Medical School, Pond Street, Hampstead, London NW3 2QG, UK
Correspondence to: Professor Walker-Smith
Submitted 6 September
1999;
Accepted 16 November 1999
| The first 150 words of the full text of this article appear below. |
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Introduction |
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Children with chronic inflammatory bowel disease in the UK are still often cared for by general paediatricians with the assistance of adult gastroenterologists or surgeons. This is not the case in North America or much of Europe. Juvenile onset Crohn's disease is an increasing problem as a recent report from Scotland indicates.1 Both diagnosis and management are complex and the time has come for all children with these disorders to be at least reviewed in a tertiary centre for paediatric gastroenterology2 in order to improve the delivery of care.
There is clearly an important genetic aspect to inflammatory bowel disease. There is some evidence that genetic anticipation may occur to explain the tendency for children to be younger than their parents at diagnosis but some relate this to ascertainment.3
Delay in diagnosis is a common feature in these children.4
It is often considered that partial or inadequate diagnosis is enough.
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