Colombian registry of inflammatory bowel disease in pediatrics

Background: Inflammatory bowel disease (IBD) has significantly increased over the past two decades. However, registries in Latin America remain scarce, prompting the creation of the Colombian pediatric IBD registry for patients under 18 years of age, designed as a continuous and periodically assessed database. Methods: A descriptive, longitudinal, ambispective, and multicenter observational study was conducted in children aged 0-18 years between January 1999 and December 2021. The analysis was performed based on the age of onset (Paris classification), with subdivisions for very early onset and phenotypes using the Pediatric IBD-classes algorithm. Data were collected in REDCap and analyzed with STATA 15.1. Results: A total of 209 patients were included, 54.5% male. The median age at diagnosis was 12.3 years (IQR 8.5-14.6). Phenotype distribution included: 104 (53.06%) typical ulcerative colitis (TUC), 52 (26.53%) Crohn's disease (CD), 18 (9.18%) unclassifiable IBD (U-IBD), 11 (5.61%) colonic Crohn's disease (CCD), and 11 (5.61%) atypical ulcerative colitis (AUC). The median time to diagnosis was 6.6 months, and treatment began after a median of 11.2 days. Coffee-cultivation zone 39%. Extraintestinal manifestations were reported in 43.9% of cases. Initial treatments included mesalamine ± steroids (35.86%), immunomodulators ± steroids (32%), exclusive/partial enteral nutrition (11.41%), and biologics ± immunomodulators (20.65%), which increased to 57.7% during follow-up. Relapse occurred in 53.26% of patients, while 35.32% achieved remission. Conclusions: This registry highlights the increasing incidence of pediatric IBD in Latin America, providing valuable insights into clinical presentations, diagnostic delays, treatment strategies, and outcomes, while revealing regional and global disparities.