Pancreatic Disorders in Children with Inflammatory Bowel Disease

Background and Objectives: Inflammatory bowel disease (IBD) is a chronic condition and mainly affects the intestines, however, the involvement of the other organs of the gastrointestinal tract (upper part, pancreas, and liver) have been observed. The coexistence of IBD with pancreatic pathology is rare, however, it has been diagnosed more frequently during recent years in the pediatric population. This article reviews the current literature on the most common pancreatic diseases associated with IBD in the pediatric population and their relationship with IBD activity and treatment. Materials and Methods: We performed a systematic review of data from published studies on pancreatic disorders, also reported as extraintestinal manifestations (EIMs), among children with IBD. We searched PubMed and Web of Science to identify eligible studies published prior to 25 April 2020. Results: Forty-four papers were chosen for analysis after a detailed inspection, which aimed to keep only the research studies (case control studies and cohort studies) or case reports on children and only those which were written in English. The manifestations of IBD-associated pancreatic disorders range from asymptomatic increase in pancreatic enzymes activity to severe disease such as acute pancreatitis. Acute pancreatitis (AP) induced by drugs, mainly thiopurine, seems to be the most- often-reported pancreatic disease associated with IBD in children. AP associated with other than drug etiologies, and chronic pancreatitis (CP), are rarely observed in the course of pediatric IBD. The pancreatic involvement can be strictly related to the activity of IBD and can also precede the diagnosis of IBD in some pediatric patients. The course of AP is mild in most cases and may occasionally lead to the development of CP, mainly in cases with a genetic predisposition. Conclusions: The involvement of the pancreas in the course of IBD may be considered as an EIM or a separate co-morbid disease, but it can also be a side effect of IBD therapy, therefore a differential diagnosis should always be performed. As the number of IBD incidences with concomitant pancreatic diseases is constantly increasing in the pediatric population, it is important to include pancreatic enzymes level measurement in the workup of IBD.

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Pancreatic involvement in inflammatory bowel disease: a review

Herald of Pancreatic Club ◽

10.33149/vkp.2019.03.02 ◽

2019 ◽

Vol 44 (3) ◽

pp. 23-32

Author(s):

F. S. Fousekis ◽

V. I. Theopistos ◽

K. H. Katsanos ◽

D. K. Christodouloua

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Acute Pancreatitis ◽

Bowel Disease ◽

Pancreatic Insufficiency ◽

Exocrine Pancreatic Insufficiency ◽

Pancreatic Diseases ◽

Pancreatic Involvement ◽

Multisystemic Disease ◽

Inflammatory Bowel

Inflammatory bowel disease (IBD) is a multisystemic disease, and pancreatic manifestations of IBD are not uncommon. The incidence of several pancreatic diseases in Crohn’s disease and ulcerative colitis is more frequent compared to the general population. Pancreatic manifestations in IBD include a wide heterogenic group of disorders and abnormalities of the pancreas and range from mild self-limited diseases to severe disorders. Acute pancreatitis, chronic pancreatitis, autoimmune pancreatitis, pancreatic autoantibodies, exocrine pancreatic insufficiency and asymptomatic imaging and laboratory abnormalities are included in related-IBD pancreatic manifestations. Involvement of the pancreas in IBD may be the result of IBD itself or of medications used.

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Overlap of inflammatory bowel disease and irritable bowel syndrome in the pediatric population

NeuroGastroLATAM Reviews ◽

10.24875/ngl.19000020 ◽

2020 ◽

Vol 3 (3) ◽

Author(s):

Amber H. Langshaw

Keyword(s):

Inflammatory Bowel Disease ◽

Irritable Bowel Syndrome ◽

Bowel Disease ◽

Pediatric Population ◽

Inflammatory Bowel ◽

Irritable Bowel

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Concurrent zinc and vitamin B 6 deficiencies in acutely exacerbated inflammatory bowel disease: Case reports

Nutrition in Clinical Practice ◽

10.1002/ncp.10665 ◽

2021 ◽

Author(s):

Nabeel Moon ◽

Bradley Figgins ◽

Ellery Altshuler ◽

Angela Pham ◽

Amir Y. Kamel

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Case Reports ◽

Vitamin B ◽

Disease Case ◽

Inflammatory Bowel

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Patients’ Diets and Preferences in a Pediatric Population with Inflammatory Bowel Disease

Canadian Journal of Gastroenterology ◽

10.1155/1998/928706 ◽

1998 ◽

Vol 12 (8) ◽

pp. 544-549 ◽

Cited By ~ 27

Author(s):

Timothy J Green ◽

Robert M Issenman ◽

Kevan Jacobson

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Pediatric Population ◽

Symptomatic Relief ◽

Sole Source ◽

Dietary Practices ◽

Pediatric Inflammatory Bowel Disease ◽

Diet Supplement ◽

Corn Products ◽

Inflammatory Bowel

PURPOSE: To determine the dietary practices of the pediatric inflammatory bowel disease population at the Children's Hospital of the Hamilton Health Sciences Corporation and the reported effectiveness of those diets.PATIENTS AND METHODS: A questionnaire mailed to 153 pediatric patients was returned by 125 patients (76 Crohn's disease [CD] and 49 ulcerative colitis [UC] patients) - an 82% response rate.RESULTS: The median age of respondents was 13 years, and 62% were male. Ninety per cent and 71% of CD and UC patients, respectively, had changed their diets since diagnosis. Caloric supplements (eg, BOOST [Mead Johnson Nutritionals]), sole source nutrition, low fibre and lactose-free diets were used by more than 15% of CD patients, whereas lactose-free, nonspicy, low acid, additive-free, caloric supplement and low fibre diets were used by more than 15% of UC patients. A diet supplement was more commonly used in CD patients (P<0.05) and an additive-free diet in UC patients. Corn and corn products, nuts, milk and bran were avoided by more than 20% of CD and UC patients; however, more CD than UC patients avoided corn and corn products. In addition, UC patients (more than 20%) also avoided tomato, other dairy (nonfluid milk-based products and foods containing milk products), chocolate, cheese, wheat, tomato sauces and fruit juice. A benefit was reported for 103 of 141 reported diets, with the most commonly alleviated symptoms being abdominal pain, diarrhea and flatulence.CONCLUSION: Many children with inflammatory bowel disease have altered their diets to manage their disease and have attributed symptomatic relief to these diets.

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Obstructive Giant Inflammatory Polyposis: Is It Related to the Severity or the Duration of the Inflammatory Bowel Disease? Two Case Reports

Case Reports in Gastrointestinal Medicine ◽

10.1155/2018/3251549 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Antoine Abou Rached ◽

Jowana Saba ◽

Leila El Masri ◽

Mary Nakhoul ◽

Carla Razzouk

Keyword(s):

Inflammatory Bowel Disease ◽

Surgical Resection ◽

Bowel Disease ◽

Transverse Colon ◽

Case Reports ◽

Rare Complication ◽

Inflammatory Bowel ◽

Inflammatory Polyposis ◽

One Year

We report two cases of giant inflammatory polyposis (GIP) with totally different presentation and evolution. The first patient had two giant pseudopolyps after one year of the diagnosis of UC. The second patient had one obstructive giant pseudopolyp secondary to CD at the level of the transverse colon, being totally asymptomatic years before the presentation. GIP is a rare complication of inflammatory bowel disease (IBD). It consists of numerous filiform polyps that look like a “mass of worms” or a “fungating” mass. Surgical resection is inevitable when GIP presents with obstructive symptoms.

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