Wolf, M. (Mathies) (2021) Celiac disease and inflammatory bowel disease in children in primary care. thesis, Medicine.
Full text available on request.Abstract
Introduction: Celiac disease (CD) and inflammatory bowel disease (IBD) are rare but serious paediatric gastrointestinal (GI) diseases. A delayed diagnosis of CD or IBD can lead to severe complications and chronic unexplained complaints. For the GP, it is a diagnostic challenge to differentiate between these organic diseases and functional gastro-intestinal disease We aim to describe GP-delay and the symptoms during first presentation of both diseases in primary care. Methods: In this retrospective cohort study, children from 2-17 years were included based on their International Classification of Primary Care (ICPC) code and a referral to a paediatrician for diagnostic work-up in the period from 2015-2020. Data was collected from the GP registry record. We identified their first presentation with a consensus panel and described their symptoms and the GP’s management (including referral). Results: In total 76 children were included in whom 37 (48.7%) had CD and 39 (51.3%) had IBD. We found a diagnostic delay of 1.35 months (IQR 0.08 – 15.1) in children with CD and 1.61 months (IQR 0.13 – 16.1) in children with IBD. Predictors for diagnostic delay (> median diagnostic delay) could not be identified. The most common presenting symptoms were abdominal pain, diarrhea and growth retardation in children with CD. In children with IBD, the most common presenting symptoms were abdominal pain, diarrhea and rectal bleeding. In both CD and IBD there was a wide variety of presenting symptoms. Conclusion: For both CD and IBD the diagnostic delay was shorter than expected. Furthermore, we showed that children with both CD and IBD present with a varying pattern of symptoms, which underpins the challenging task for GPs. Further prospective research is needed to evaluate the opportunities of reducing diagnostic delay in primary care.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Ansems, dr. S.M. and Berger, prof. dr. M.Y. |
| Faculty: | Medical Sciences |
| Date Deposited: | 07 Jan 2022 09:21 |
| Last Modified: | 07 Jan 2022 09:21 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2990 |
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