Abstract

Purpose Pediatric Ulcerative Colitis (UC) is an Inflammatory Bowel Disease (IBD) that has potential morbidities, lifelong challenges and can leave both physical and psychosocial impacts. This study aimed to review the epidemiology, clinical presentations, and way of diagnosis, therapeutic approaches, complications and outcome of pediatric patients with UC. Methods A retrospective review of all patients diagnosed with UC in the pediatric department, Salmaniya medical complex, Bahrain, between 1984 and 2017 was conducted. Annual incidence and cumulative prevalence were calculated. Data about demographic and clinical characteristics; laboratory, radiological, endoscopic and histological investigations; medical therapy, number of exacerbations and hospital admissions, complications and outcomes were collected. Results Out of 108 pediatric patients diagnosed with IBD, 58 (53.7%) patients were found to have UC. The estimated annual incidence was 1/105/year (range from 0 to 6 patients). The prevalence was 16.3 patients per 100,000 pediatric populations. Thirty-three (56.9%) were females and 25 (43.1%) were males. Median age at the time of study was 22.9 years (range 5.8 to 41.8). The most common clinical presentations were bloody diarrhea and recurrent abdominal pain. Family history of IBD was found in five patients. Twenty-four (41.4%) patients had associated diseases. Ten (71.4%) patients had positive Anti-Neutrophil Cytoplasmic Antibodies (ANCA) test. Forty (81.6%) patients had pancolitis. The most frequent medications were prednisolone, mesalazine and azathioprine. Biological therapies were used in eight. Surgical intervention was required in nine. Four patients had colectomy. Two patients died at the age of 17 and 26 years. Both had an associated liver diseases and one died because of colon cancer. Conclusions The study showed a significant increase in incidence and prevalence of UC in Bahrain. Female predominance and a high association with autoimmune diseases might support the autoimmune theory as a cause for the disease. Despite medical therapy, significant morbidities and mortalities were reported.

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