Crohn's disease different in boys than in girls

NEW YORK (Reuters Health) - Crohn's disease tends to be more severe in girls than in boys, but boys with the disorder are more prone to stunted growth, new research suggests.

Crohn's disease, along with ulcerative colitis, is a serious inflammatory bowel disease (IBD). The inflammation can occur anywhere in the digestive system from the mouth to the anus, although it is most often found in the small and large intestines. The disease, which can cause abdominal pain, bloating, and diarrhea, is treated with various medications or when an intestinal blockage occurs, with surgery.

"Gender differences in the course of Crohn's disease are unclear," Dr. Melvin B. Heyman at the University of California, San Francisco, and colleagues state in the journal Pediatrics. Identifying how the disease is expressed differently according to gender can improve our understanding of the cause, underlying disease process, and the natural history of Crohn's disease.

Using the Pediatric IBD Consortium Registry, Heyman's team compared 566 boys and 423 girls diagnosed with Crohn's disease before they were 17 years old. The patients were followed for 3.6 years, on average.

Girls had a higher rate of mouth sores and lower blood levels of a protein called albumin, suggesting the presence of malabsorption syndrome. In addition, girls also were at greater risk for common skin rashes seen with the disease and usually required intestinal surgery before boys.

Cyclosporine, a common immune-suppressing drug, was used more often among girls, most likely reflecting more severe disease that doesn't respond to first-line drugs, the authors suggest.

As noted, boys were more likely than girls to develop growth failure: 12.6 versus 4.0 percent, respectively.

Heyman and his team call for further studies to examine gender differences in Crohn's disease.

SOURCE: Pediatrics, December 2007.