Management of growth failure in Crohn's disease.

Crohn's disease is one of the chronic inflammatory bowel diseases which at present is still of unknown cause. It has been known for some time that this disorder may lead to significant impairment of linear growth' and delay in the onset of puberty. Indeed Crohn's disease in childhood may present as short stature or delay in pubertal maturation without any gastrointestinal symptoms. There may be irreversible consequences in terms of reduced potential for height unless this diagnosis is made promptly and treatment instituted to induce remission of disease activity, thus permitting restoration of normal growth.2 A full blood count, erythrocyte sedimentation rate, and C reactive protein estimation should be standard screening tests for short stature.' In this paper I shall give an account of my own personal practice in the management of children with Crohn's disease and chronic inflammatory bowel disease in the paediatric inflammatory bowel disease clinic which was first established at St Bartholomew's Hospital in 1978 and transferred to the Royal Free Hospital in 1995.