Diagnostic delay in pediatric inflammatory bowel disease: preliminary data from a Tertiary Center in Northern Italy

Introduction : Diagnostic delay (DD) in pediatric inflammatory bowel disease (IBD) is not well described. The aim of our study is describe DD in our population of patients and identify potential influencing factors. Methods We retrospectively reviewed clinical records of IBD patients diagnosed at “V. Buzzi” Childrens’ Hospital. Demographic and clinical data were collected. We defined total DD (time between first symptoms to diagnosis >6 months), patient DD (time from symptoms and first medical examinations), healthcare DD (time between first medical examinations and diagnosis). Potential factors influencing DD were identified using chi2-test. Results 107 patients (CD 57, UC 50, IBD-U 1) were included. Median age at diagnosis 11.5 years. Median total DD was 6.2 months (IQR= 1-23) in CD, 5 months (IQR=1-28) in UC. Total median patient DD was 2.8 months (3.1 CD, 2.5 UC). Total median healthcare DD was 3.68 months (4.6 CD, 2.76 UC). In CD, diarrhoea and perianal disease occurred less frequently in DD (p = 0.017 and p=0.08), abdominal pain and ileal disease were more frequent in DD (p = 0.5 and p = 0.5). In UC, bloody diarrhoea was less frequently seen in DD compared to diagnosis before 6 months (p = 0.9). Conclusions DD was more frequent in CD compared to UC, with longer healthcare DD compared to patient DD. In CD diarrhoea and perianal disease seem protective for DD while ileal disease and abdominal pain could be risk factors for DD. However, our sample is small, larger-scale studies are needed to clarify which factors significantly impact on DD.