Walker-Smith John
Medicine, Wellcome Trust Centre for History of Medicine, University College, London.
Clin Med (Lond). 2008 Jun;8(3):292-5. doi: 10.7861/clinmedicine.8-3-292.
Between 1966 and 2000 the pattern of gastroenterological disease in children in developed communities changed. Clinically severe infective gastroenteritis has declined in incidence. Infection of children with the conventional serotypes of Escherichia coli dramatically declined. During this period many new infective agents notably rota virus were recognised. By contrast, more children with chronic inflammatory bowel disease (IBD), especially Crohn's disease, have been diagnosed than ever before. Gastrointestinal allergy is increasingly recognised but the pattern of disease has changed. Technological advance in accurate diagnosis occurred with an emphasis upon tissue diagnosis. Introduction to clinical practice of ileocolonoscopy in the late 1970s immensely increased the ability to make the diagnosis of chronic IBD in children. Therapeutic advance has seen development of parenteral nutrition and enteral feeding as major therapies for children. In the UK there has been a rise and fall in university departments of paediatric gastroenterology.
1966年至2000年间，发达社区儿童的胃肠疾病模式发生了变化。临床上严重感染性肠胃炎的发病率有所下降。儿童感染传统血清型大肠杆菌的情况显著减少。在此期间，许多新的感染因子，尤其是轮状病毒被发现。相比之下，被诊断患有慢性炎症性肠病（IBD），尤其是克罗恩病的儿童比以往任何时候都多。胃肠道过敏越来越受到关注，但疾病模式发生了变化。精确诊断技术取得了进步，重点在于组织诊断。20世纪70年代末回结肠镜检查引入临床实践，极大地提高了儿童慢性IBD的诊断能力。治疗方面的进展包括将肠外营养和肠内喂养发展为儿童的主要治疗方法。在英国，儿科胃肠病学大学系经历了兴衰。
