While some pediatric patients present with signs and symptoms typical for an inflammatory bowel disease (IBD), others have only vague symptoms or they may present with extraintestinal findings.


Many pediatric patients do not present with the "classic" triad of:

(1) abdominal pain

(2) diarrhea with or without blood and/or mucus

(3) weight loss.


This may cause a delay in diagnosis.


A pediatric patient may present with one or more of the following findings:

(1) a family history of IBD in a first degree relative

(2) rectal bleeding

(3) lethargy

(4) anorexia

(5) nausea and vomiting

(6) malaise

(7) abdominal discomfort

(8) fever

(9) failure to thrive or growth retardation

(10) malnutrition

(11) a psychiatric disorder

(12) peripheral and/or axial arthritis

(13) skin lesions (erythema nodosum, pyoderma gangrenosum)

(14) delayed puberty

(15) menstrual irregularities in females

(16) perianal disease (anal fistula, abscess, ulcer)

(17) constipation or soiling

(18) toxic megacolon

(19) right lower quadrant pain simulating appendicitis

(20) unexplained liver disease


It is important to consider an inflammatory bowel disease in a pediatric patient with any of these findings, especially when they are recurrent or persistent.


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