Growth after intestinal resection for Crohn's disease in children, adolescents, and young adults

Objective: Growth before and after intestinal resection for Crohn's disease (CD) was examined in a group of children, adolescents, and young adults. Methods: Retrospective chart review of patients who had intestinal resections as clinical management of complications of CD between 1985 and 1996. Pre- and postoperative measurements of weight and height were reviewed. Z-scores were computed for weight-forage (WAZ), height-for-age (HAZ), and weight-for-height (WHZ). Two tailed t tests were used to compare postoperative growth patterns. Significance was defined as p < 0.05. Results: Twenty-five subjects (8 females, mean age 16.2 +/- 2.8 years with one operation, and 3 males, mean age 15.7 years with multiple operations) were identified. There were significant improvements in the postoperative growth patterns of subjects who had one operation: HAZ (-1.28 +/- 1.45 versus -0.98 +/- 1.37, p = 0.041), WAZ (-1.35 +/- 1.02 versus -0.74 +/- 0.93, p = 0.0006) and WHZ (-0.64 +/- 0.95 versus -0.23 +/- 0.81, p = 0.036). Furthermore, the magnitude of postoperative weight gain directly correlated with the age at CD diagnosis, R-2 = 0.16, p = 0.046. Trends towards improved postoperative WAZ (-0.83 versus -0.49) and HAZ (-0.47 versus -0.27) were also observed in the three subjects who had multiple operations. Conclusion: The pattern of weight and height growth was improved after intestinal resection for CD. Nonetheless, close monitoring of postoperative growth is necessary especially in children diagnosed with CD at a young age.