Delays in Diagnosing Pediatric Inflammatory Bowel Disease in Korea: Impact on Disease Severity and the Need for Early Recognition

Background: A delayed diagnosis of pediatric inflammatory bowel disease (IBD) can lead to adverse outcomes. This study aimed to analyze the diagnostic delay among pediatric patients with IBD, focusing on associations with disease classification, disease activity, and initial management. Methods: This multicenter retrospective study included pediatric patients who had been diagnosed with IBD across 17 Korean medical centers. Clinical and demographic data were extracted from their medical records. Results: Overall, 486 patients, 362 with Crohn’s disease (CD) and 124 with ulcerative colitis (UC), were included in the study. The median diagnostic delay, defined as the interval between initial symptom onset and final diagnosis of IBD, was not significantly different between CD and UC (P = 0.154); however, the interval from symptom onset to the first physician visit was significantly longer than that from the physician visit to diagnosis for both CD and UC (P = 0.004). Regarding CD, a long diagnostic delay was associated with fewer extraintestinal symptoms, lower C-reactive protein levels, and lower symptom scores. Conclusion: Significant diagnostic delays are primarily due to prolonged intervals between symptom onset and the first physician visit. Public awareness campaigns about IBD symptoms tailored to the growing number of pediatric IBD patients in Korea could be a crucial factor for early diagnosis.