Reason for large increase in hospitalizations of children with IBD unclear, researchers report

Researchers from UH Rainbow Babies & Children's Hospital report reasons behind the increase are unclear

The largest investigation to date has found a dramatic increase in the number of hospitalizations for children with inflammatory bowel disease (IBD) during the past decade in the United States.

The new study, published online and scheduled for the August 2013 print issue of the Journal of Investigative Medicine, found a 65 percent increase in IBD hospital discharges from 2000 to 2009. The number increased from 11,928 discharges in 2000 to 19,568 discharges in 2009.

IBD refers to a group of inflammatory conditions of the colon and small intestine. The major types of IBD are Crohn's disease (CD) and ulcerative colitis (UC). When looking at these two types of IBD individually, the authors found a 59 percent increase in CD discharges and a 71 percent increase UC discharges.

The study looked at more than 11 million hospitalization records of patients 20 years old and younger using a federal children's inpatient database. For the decade, they identified more than 61,000 pediatric discharges with an IBD diagnosis.

According to the study's principal investigator, Thomas J. Sferra, MD, Division Chief of Pediatric Gastroenterology and Nutrition at UH Rainbow Babies & Children's Hospital and Associate Professor of Pediatrics at Case Western Reserve University School of Medicine, this increasing trend was present in each age category and across all geographic regions (Northeast, Midwest, South and West).

"The reason for this large increase in hospitalizations of children with IBD is not clear," said Dr. Sferra. "We also found an increase in IBD-related complications and co-existing conditions which suggest an increase in the severity of this disease has contributed to a greater need for hospitalization. However, we will need to perform more research to determine whether patients were admitted to the hospital due to IBD or for an unrelated medical condition. Also, while we're seeing more kids being discharged with IBD, we cannot with certainty say that the incidence and prevalence of childhood IBD has increased in U.S."

The trend found by this nationwide study reflects what appears to be a phenomenon that has been reported for specific regions within the US and for other countries -- Canada, Scotland, and Finland.