Inflammatory Bowel Disease in Jordanian Children: A Tertiary Center Experience

Abstract

Purpose: This study describes the clinical features, disease subtypes, laboratory findings, and outcomes of pediatric inflammatory bowel disease (IBD) in Jordan, with the aim of comparing regional and global trends. Methods: We conducted a retrospective review of the medical records of patients diagnosed with IBD before the age of 18 years, who were followed up at the pediatric gastroenterology clinic at Jordan University Hospital between January 2015 and December 2022. The diagnoses were based on the revised Porto criteria. Results: A total of 31 patients (61.3% male) were included in this study. The mean age at diagnosis was 8.7±4.75 years. Very early onset IBD (VEO-IBD) accounted for 38.7% of all cases. Crohn disease (51.6%) was more common than ulcerative colitis (UC) (29.0%) or unclassified IBD (19.4%). Diarrhea and abdominal pain were the most common symptoms. Steroids were used for remission induction in 90.3% of the cases, and %-aminosalicylic acid (5-ASA) was the most common maintenance therapy (48.4%). In CD patients, ileocolonic involvement (L3) was the most common (5, 29.4%), with non-stricturing, non-penetrating behavior (B1) in (10, 58.8%). Among UC patients, pancolitis was the predominant phenotype (3, 37.5%). C-reactive protein (CRP) level and erythrocyte sedimentation rate (ESR) were elevated in (19, 61.3%) patients, while ESR was elevated in (16, 51.6%) patients, respectively. Anemia was observed in more than half of the patients (18, 58.1%). Steroid remission was steroids in (28, 90.3%) patients. 5-ASA was the most common maintenance therapy used in our cohort (15, 48.4%). Biological therapy was used to (8, 25.8%) patients. Conclusion: Crohn’s was more prevalent than UC in the pediatric cohort. Limited access to biologics and frequent treatment escalations highlight the need for improved therapeutic options and the development of a national IBD registry.