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Background: Urolithiasis is rare in pediatric patients. All patients with inflammatory bowel disease (IBD) have an increased risk of urolithiasis, but this risk is poorly quantified in children. The objective of this study is to evaluate the association of IBD with urolithiasis, assess surgical outcomes, and analyze the financial burden for children hospitalized with urolithiasis and comorbid IBD., Methods: The triennial Healthcare Cost and Utilization Project Kids' Inpatient Database for years 1997 to 2012 was used to evaluate the association between urolithiasis and IBD in hospitalized, nonpregnant children ages 5 to 20 years old. Billing codes were used to define conditions. Logistic regression analysis quantified the association between IBD types and urolithiasis. Length of hospital stay, costs, procedures, and complications were compared between urolithiasis patients with and without IBD., Results: Among 8,828,522 hospital admissions, we identified 36,771 admissions with a primary diagnosis of urolithiasis. Of these cases, 230 were associated with Crohn's disease (odds ratios, 1.99; 95% confidence interval, 1.74-2.27) and 102 with ulcerative colitis (odds ratio, 1.63; 95% confidence interval, 1.34-1.99). Urolithiasis patients with ulcerative colitis, but not Crohn's disease, had significantly increased length of stay and costs. Patients with either IBD had a decreased number of urologic procedures., Conclusions: The diagnosis of urolithiasis in pediatric patients is associated with IBD, and those with ulcerative colitis have longer hospital stays and greater costs. Patients with IBD have fewer urologic procedures associated with their urolithiasis diagnosis.

Background: Little is known about the impact of video capsule endoscopy (VCE) on decision making in pediatric patients with IBD. Moreover, few studies have reported on the outcomes of treatment changes made based on VCE findings. Our aim was to identify the added value of VCE in pediatric patients in a tertiary IBD center with established or suspected IBD, by assessing changes in treatments and outcomes before and after VCE., Methods: A retrospective chart review was performed in children with established (n = 66) or suspected (n = 17) IBD who underwent VCE. Diagnostic classifications, treatments, and clinical outcomes before and 1 year after VCE were compared., Results: Primary indications for VCE included patients treated for Crohn's disease (CD) with poor growth or active symptoms (60%), patients with ulcerative colitis/IBD-unclassified (19%), and suspected IBD (20%). Abnormal VCE was seen in 86% of patients with CD, of whom 75% underwent treatment escalation. One year after VCE, patients with CD improved in growth (mean z-scores at baseline and 12 months, -0.5 and 0.2, respectively; P < 0.0001), mean body mass index (18.3 and 19.8, respectively; P = 0.004), mean erythrocyte sedimentation rate (25 versus 16, respectively; P = 0.012), and median Harvey-Bradshaw Index (2 and 0, respectively; P = 0.003). VCE revealed more extensive disease than concurrent imaging modalities in 43% of the patients with CD. VCE "ruled out" IBD in 94% who had suspected IBD, whereas 50% with presumed ulcerative colitis/IBD-unclassified had a diagnosis changed to CD., Conclusions: VCE provides additional clinical information that impacted management of pediatric patients with IBD in a tertiary IBD center and was associated with improved outcomes.