Focally enhanced gastritis (FEG) is characterized by small collections of lymphocytes and histiocytes surrounding gastric crypts. Previous studies have suggested that this condition is associated with IBD. Data from the paediatric population, however, are scarce.

Giorgos Choulairas and colleagues conducted a retrospective study to investigate the prevalence of FEG in children with IBD and to assess the ability of FEG to distinguish patients with IBD from those without. Notably, problems with a definitive diagnosis of IBD are quite common in children.

869 children were included in the study: 185 children with IBD and 684 without IBD (who were undergoing an endoscopy for investigation of abdominal complaints). FEG was found significantly more frequently among children with IBD (35.7% versus 3.4%, respectively; P <0.001). “We feel that this could be of considerable prognostic value in cases of normal or incomplete ileocolonoscopy and inconclusive histopathological findings,” says Choulairas. Another interesting finding was that FEG was much more common in females than males; in children with unclassified IBD, it was more common in children <2 years old.

“A planned extension of this project is to contact the 23 non-IBD children with FEG to investigate if they subsequently developed any gastrointestinal pathology that was not present, or not clinically evident, at the time of their first endoscopy,” concludes Choulairas.