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Inflammatory Bowel Disease in Children and Adolescents
Michael J Rosen1, Ashish Dhawan1, Shehzad A Saeed1
1Schubert-Martin Inflammatory Bowel Disease Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio2Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Insights
Inflammatory bowel diseases (IBD) affect children and adolescents, often presenting with nonclassic symptoms. Early diagnosis and tailored management are crucial for growth, development, and quality of life in pediatric IBD patients.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Clinical Medicine
Background:
- Inflammatory bowel diseases (IBD), encompassing ulcerative colitis and Crohn disease, are chronic gastrointestinal inflammatory conditions.
- IBD incidence is rising in pediatric populations, frequently diagnosed in adolescents and young adults.
- The underlying cause is a dysregulated mucosal immune response in genetically susceptible individuals interacting with intestinal microflora.
Purpose of the Study:
- To offer a current review of pediatric inflammatory bowel diseases.
- To cover epidemiologic features, pathogenesis, diagnostic approaches, and management strategies for IBD in children and adolescents.
Main Methods:
- This review synthesizes current literature on pediatric inflammatory bowel diseases.
- It examines diagnostic criteria and therapeutic goals specific to the pediatric population.
Main Results:
- Children may exhibit classic IBD symptoms (weight loss, abdominal pain, bloody diarrhea) or nonclassic signs (poor growth, anemia, extraintestinal manifestations).
- Therapeutic objectives include symptom elimination, improved quality of life, growth restoration, and complication prevention while minimizing medication side effects.
Conclusions:
- Pediatric IBD management requires special consideration for growth, bone health, and psychosocial well-being.
- Effective treatment necessitates a comprehensive approach addressing both disease activity and the unique developmental needs of children and adolescents.
Abstract:
The inflammatory bowel diseases (IBDs), including ulcerative colitis and Crohn disease, are chronic inflammatory disorders of the gastrointestinal tract most often diagnosed in adolescence and young adulthood, with a rising incidence in pediatric populations. These disorders are common enough in children that most pediatricians and other pediatric clinicians will encounter children with IBD in their general practice. Inflammatory bowel disease is caused by a dysregulated mucosal immune response to the intestinal microflora in genetically predisposed hosts. Although children can present with the classic symptoms of weight loss, abdominal pain, and bloody diarrhea, many present with nonclassic symptoms of isolated poor growth, anemia, or other extraintestinal manifestations. Once IBD is diagnosed, the goals of therapy consist of eliminating symptoms, normalizing quality of life, restoring growth, and preventing complications while minimizing the adverse effects of medications. Unique considerations when treating children and adolescents with IBD include attention to the effects of the disease on growth and development, bone health, and psychosocial functioning. The purpose of this review is to provide a contemporary overview of the epidemiologic features, pathogenesis, diagnosis, and management of IBD in children and adolescents.
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