Management of growth retardation in the young patient with Crohn's disease

Expert Opin Pharmacother. 2002 Jan;3(1):1-7. doi: 10.1517/14656566.3.1.1.

Abstract

Linear growth retardation is a major complication of Crohn's disease that occurs in children. It is related both to undernutrition and to direct effects of the inflammatory process on the growth axis. Enteral nutrition (elemental, semi-elemental or polymeric diet) employed as the sole source of nutrition remains a mainstay of treatment of active Crohn's disease because it corrects nutritional deficits, has anti-inflammatory effects, heals mucosal inflammation and stimulates growth. Conventional corticosteroids have adverse effects on growth and preliminary data suggest that an ileal-release preparation of budesonide may also suppress linear growth. 6-Mercaptopurine (6-MP) and its prodrug azathioprine maintain remission in children with Crohn's disease. These treatments thus have the potential to improve growth velocity and final adult height.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use*
  • Budesonide / therapeutic use*
  • Child
  • Child Nutritional Physiological Phenomena
  • Crohn Disease / complications*
  • Crohn Disease / drug therapy*
  • Diet
  • Growth Disorders / etiology*
  • Humans
  • Mercaptopurine / therapeutic use*

Substances

  • Adrenal Cortex Hormones
  • Budesonide
  • Mercaptopurine