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Crohn disease and ulcerative colitis in children: an update for 2014
Daniel A Lemberg1, Andrew S Day
1Department of Gastroenterology, Sydney Children's Hospital, Sydney, New South Wales, Australia; School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
Insights
Inflammatory bowel disease (IBD), including Crohn disease and ulcerative colitis, is rising in Australasian children, often presenting more severely. Early diagnosis and multidisciplinary care are crucial for optimal outcomes in pediatric IBD.
Area of Science:
- Pediatric Gastroenterology
- Immunology
Background:
- Inflammatory bowel disease (IBD), encompassing Crohn disease (CD) and ulcerative colitis (UC), shows increasing prevalence in Australasian pediatric populations.
- Pediatric IBD cases are diagnosed at younger ages and often exhibit more extensive disease and severe courses compared to adult counterparts.
- Children with IBD may present with atypical symptoms beyond gastrointestinal issues, including oral ulcerations, growth impairment, and dermatological manifestations, impacting linear growth and pubertal development.
Purpose of the Study:
- To highlight the increasing incidence and unique characteristics of pediatric inflammatory bowel disease in Australasia.
- To emphasize the importance of early identification and comprehensive assessment in managing pediatric IBD.
- To underscore the necessity of a multidisciplinary, family-centered approach to IBD management in children.
Main Methods:
- Review of epidemiological trends in pediatric IBD in Australasia.
- Analysis of clinical presentation variations in children versus adults.
- Discussion of diagnostic challenges and management strategies for pediatric IBD.
Main Results:
- Significant rise in pediatric Crohn disease and ulcerative colitis incidence in Australasia.
- Younger age of onset and more severe disease phenotypes observed in pediatric IBD patients.
- Growth and nutritional disturbances are common complications affecting pediatric IBD patients.
Conclusions:
- Early and thorough evaluation of children with suspected IBD is critical to mitigate diagnostic delays and improve outcomes.
- Comprehensive management requires a multidisciplinary team approach, focusing on the child and their family.
- Addressing altered growth and nutrition is paramount for optimizing long-term health and development in pediatric IBD patients.
Abstract:
Crohn disease (CD) and ulcerative colitis (UC), the two main types of inflammatory bowel disease (IBD), have become increasingly common in Australasian children and adolescents in recent years. Furthermore, CD and UC are seen more often in younger children. These conditions are typically more extensive in children and tend to follow more severe disease courses than in adults. Although many children may present with typical symptoms (such as abdominal pain or bloody diarrhoea), others have atypical features (including oral ulceration, short stature or skin manifestations). In addition, many children with IBD will have altered growth or nutrition, which may compromise normal linear growth and pubertal development. Early identification and full assessment of children presenting with possible IBD are essential to avoid consequences of diagnostic delay and to optimise short- and long-term outcomes. Management of IBD encompasses various options and should be undertaken within a team-based, child and family-focused, multidisciplinary setting.
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