6786 Clinical profile and therapeutic practices related to pediatric inflammatory bowel disease : a single centre experience from India

Objectives Recent years have witnessed an increase in Pediatric inflammatory bowel disease (PIBD) across the world.¹ Despite being identified as one of the major health capitals of India, there is paucity of epidemiological data on PIBD from the state of Kerala. Hence we tried to study the demographic clinical profile and management practices related to pediatric inflammatory bowel disease (PIBD) in a tertiary care hospital in South India. Also to know the delay in diagnosis of PIBD and its impact on the outcome of disease. Methods Prospectively maintained data of consecutive children with PIBD diagnosed on the basis of revised Porto criteria between February 2018 and July 2023 were analysed retrospectively. All children below 16 years who presented with clinical symptoms and signs suggestive of PIBD underwent a basic evaluation which was followed by upper gastrointestinal endoscopy and ileocolonoscopy with segmental biopsy other investigations as indicated, treatment practices and outcomes were followed up. Results 30 children were diagnosed with PIBD, with a median age of 9.5 (IQR 8.5–11) years and a male-female ratio of 2.3:1. 24. 80% (24) were diagnosed to have Crohn's disease (CD), 13% (4)ulcerative colitis (UC), and 7% (2) unclassified with a mean diagnostic delay of 16 (SD 11.8) months. Most CD (96%) had ileocolonic disease, and 75% UC had extensive/pancolitis. Abdominal pain (79%), diarrhoea (63%), and growth failure (92%), were significantly high in CD than in UC (p < 0.01). Extra intestinal manifestations were noted in 90% of patients (recurrent oral aphthous ulceration 83%). Poor BMD was noted in 66%. Three children had received anti-tuberculous therapy prior to being diagnosed with CD. Corticosteroids, mesalamine and azathioprine were the most commonly used medications, while 15 (50%) patients received biologics [adalimumab- 40% CD, infliximab- 50% UC, 12.5% CD, and ustekinumab- 4% CD]. Over a median follow-up of 12 (IQR 8–24) months, remission was attained in 83% of cases. Conclusion CD is more common than UC among PIBD in our study. The delay in diagnosing PIBD points to need to create awareness among paed iatricians to generate high index of suspicion. Use of biologicals is more compared to largest available Indian data. References Srivastava A, Sathiyasekharan M, Jagadisan B, et al. Paediatric inflammatory bowel disease in India: a prospective multicentre study. Eur J Gastroenterol Hepatol 2020 Oct;32(10):1305–1311. Sood A, Kaur K, Mahajan R, et al. Colitis and Crohn's Foundation (India): a first nationwide inflammatory bowel disease registry. Intest. Res 2021;19:206–16.