Extraintestinal manifestations

Approximately 25-35 of patients with IBD develop extraintestinal symptoms.88,89 Extraintestinal manifestations of IBD may occur before, during, or after the development of gastrointestinal symptoms and may appear after surgical removal of diseased bowel.88,90-93 The clinical activity of the extraintestinal manifestations may or may not correlate with the activity of intestinal inflammation. Joint manifestations (arthropathy) occur in 5-20 of children with ulcerative colitis.4,90 These can be...

Differential diagnosis

A number of clinical features 'red flags' are commonly considered as orienting towards an organic etiology, although definitive proof for their predictive value is scant. Elements that have been classically associated with a greater likelihood of an organic condition are listed in Table 14.2. The presence of an isolated symptom such as isolated abdominal pain is usually thought to be consistent with a functional disorder, while multiple symptoms such as abdominal pain with weight loss, or...

Clinical signs and symptoms

Swollen Lips Oral Crohns

The initial clinical presentation of Crohn's disease may be subtle, variable, non-specific and easily overlooked. Common symptoms include abdominal pain, diarrhea and or weight loss.103 A plateau in linear growth, delayed pubertal development, perianal lesions, fever, pallor, hematochezia and digital clubbing may also be present.103 Crohn's disease may affect any area of the gastrointestinal tract from the lips to the perianal area. In a study on Scottish children and adolescents with Crohn's...

Yersinia

Yersinia enterocolitica and Y pseudotuberculosis are two important human enteropathogens distributed widely in the environment, with swine serving as the major reservoir. The incubation period is 3-7 days, with food-borne transmission the suspected route for most infections. Yersinia's preference for cool temperatures makes this pathogen more common in Northern Europe, Scandinavia, Canada, the USA and Japan, where it is responsible for up to 8 of sporadic diarrhea episodes. Yersinia...