الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
IBD is a chronic disorder of intestinal inflammation characterized by remitting and relapsing course. It encompasses diseases which include Crohn’s disease (CD), ulcerative colitis (UC) and IBD-unclassified (IBD-U). It was traditionally assumed to be an adulthood disease affecting people of European descent. However, it has now emerged as a global disease affecting individuals of every age, ethnicity, and geographic region. This creates a new field of research to explore similarities and differences in disease presentations and outcomes in different age groups across different geographic regions and ethnic groups.
The aim of the work was to compare the presentation, clinical course, and outcome of inflammatory bowel disease in the different pediatric age groups at Alexandria University Children’s Hospital (AUCH).
This retrospective comparative descriptive study was based on medical records of 133 IBD patients aged from birth to 18 years who attended the Gastroenterology Clinic at AUCH in a three-year period (from June 2017 to June 2020). Data retrieved from patients’ files included demographic data, clinical presentation, clinical examination at diagnosis, diagnostic work up, different used treatment lines (including surgery). Patients were categorized and compared based on the age of onset into three main age groups [VEO-IBD:<6 years (20%), EO-IBD:6-<10 years (34.6%), and PO-IBD:10-17 years of age (45%)].
Statistical analysis of data obtained from the present study showed the following results:
1. Twelve percent of the studied cases group presented with infantile disease onset (< 2 years of age) including three patients with neonatal onset.
2. All the studied IBD patients and the three subgroups as well showed a male sex predominance (57.1%) particularly early onset CD phenotypes (VEO-CD and EO-CD).
3. Most of the EO and PO-IBD cases were from urban areas while more than half of the VEO-IBD (especially VEO-CD) cases were referred from rural areas.
4. The overall prevalence of UC and CD were equal with UC being more prevalent in VEO-IBD and PO-IBD groups.
5. Diagnostic delay was significantly longer in the VEO-IBD group (with VEO-CD > VEO-UC patients) in comparison to the two other groups.
6. Regardless of the age of onset, diarrhea and abdominal pain were the chief presenting symptoms of pediatric IBD with diarrhea being more common in patients with UC while abdominal pain more common in patients with CD.
7. Mucoid bloody diarrhea was significantly more common in VEO-CD group whereas watery diarrhea was more common in PO-CD patients.
8. Abdominal pain and vomiting were significantly more common in the EO and PO-IBD groups, while fever was significantly more common in the VEO-IBD group.
9. Fever was a main feature in VEO-IBD (both CD and UC), and it was a significant feature of CD in older children.