Modern Pediatrics. Ukraine. (2025).6(150): 46-53. doi: 10.15574/SP.2025.6(150).4653
Oshlianska O. A.^1,2, Stepaniuk Y. S.³, Doroshenko O. O.², Rudenko S. M.^3
1Shupyk National Healthcare University of Ukraine, Kyiv
²SI “Ukrainian Center of Maternity and Childhood of the NAMS of Ukraine”, Kyiv
³SNCE «National Specialized Children's Hospital “OHMATDYT” Ministry of the health of Ukraine», Kyiv

For citation: Oshlianska OA, Stepaniuk YS, Doroshenko OO, Rudenko SM. (2025). First manifestations of inflammatory bowel disease in children. Modern Pediatrics. Ukraine. 6(150): 46-53. doi: 10.15574/SP.2025.6(150).4653.
Article received: Apr 25, 2025. Accepted for publication: Sep 16, 2025.

Early clinical manifestations of inflammatory bowel diseases (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), in children are highly variable and often nonspecific, which complicates timely diagnosis. Analyzing initial symptoms is crucial for raising physician awareness and improving early detection of IBD.
Aim – to analyze the initial manifestations of IBD in children hospitalized in two leading clinical centers in Ukraine.
Materials and methods. The study included 333 children with a confirmed diagnosis of IBD, of whom 146 had CD and 187 had UC. A retrospective analysis of clinical data recorded in medical documentation was performed.
Results. The most common initial manifestations were gastrointestinal symptoms: abdominal pain, diarrhea, and pathological stool findings. At the same time, a considerable proportion of patients presented with extraintestinal manifestations, which significantly delayed the diagnosis of IBD. Anemia was the primary symptom in 108 (31.8%) of children. Joint involvement was noted at disease onset in 34 (10.0%) of patients, and skin manifestations in 9 (2.7%). In 3 (0.9%) cases, the first symptom was fever of unknown origin. The nonspecific clinical picture, especially in patients with extraintestinal onset, often resulted in diagnostic delays and prolonged the time to specialized medical care.
Conclusions. A significant proportion of patients present with extraintestinal manifestations -including joint involvement, skin lesions, hematological abnormalities, fever of unknown origin, and other signs – highlighting the need for increased awareness among primary care physicians and the use of IBD screening (e.g., fecal calprotectin) in appropriate patients. Raising physician vigilance regarding the early signs of IBD, particularly extraintestinal manifestations, applying standardized diagnostic algorithms, and employing a multidisciplinary approach contribute to timely diagnosis and prevention of complications, which is crucial for prognosis and quality of life in children.
The study complied with the principles of the Declaration of Helsinki and was approved by the institutional ethics committee. Informed consent was obtained from the patients prior to participation.
The authors declare no conflict of interest.
Keywords: inflammatory bowel disease, extraintestinal manifestations, first manifestations.

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