Pediatrics

Biography

Biography: Dr Gábor Veres

Abstract

Introduction: Despite the continuous research efforts, the exact ethiology of chronic inflammatory bowel diseases (IBD) are still largely unknown. The incidence of pediatric-onset IBD is constantly growing in Hungary. It is of note however, that the necessary evaluation of the cases according to the Porto criteria are not always conducted completely (to do upper endoscopy, entering to the terminal ileum, and evaluation of small intestine involvement with imaging techniques, preferably with MRI). Aim: The Hungarian Pediatric IBD Registry (HUPIR) is a nationwide database for prospectively registering pediatric IBD cases. The aim of our study was to evaluate the changes in adherence to the Porto criteria in the diagnostic evaluations over time according to the data of HUPIR. Results: The average incidence rate of pediatric IBD was 8.4/100 000 between 2007 and 2016. According to the data collected in HUPIR, the incidence rate elevated by 23% in this period (from 7/100 000 to 9.1/100 000). The incidence rate of Crohn’s disease elevated from 4.2/100 000 to 5.7/100 000 (26%), and the rate for colitis ulcerosa changed form 2.1/100 000 to 2.7/100 000 (22%).  The diagnostic procedure adhered completely to the Porto criteria only in 27% of the cases in the first year, but this rate improved to 46% by 2015. The frequency of illeocolonoscopic evaluation improved from 51% to 88%, in addition, the rate of upper endoscopy increased from 51% to 87% in the same period. Diagnostic assessment of the small intestine with imaging techniques was conducted in 46% of the cases registered in HUPIR. Conclusions: Based on the evaluation of data of HUPIR, the diagnostically adherence to Porto criteria grew approximately two fold in the last eight years. This improvement should be multi-factorial, but HUPIR must have a significant role in the process. Our positive experiences could stand as an example for countries where nationwide registry for IBD is not yet established.