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Current perspectives on pediatric inflammatory bowel disease focusing on transitional care management. What should we
Constanza Bay M1, Paulina Núñez F2, Rodrigo Quera3
1Department of Pediatrics, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
Insights
Inflammatory bowel disease (IBD) is rising globally, particularly in children, who often experience more severe disease. Effective management requires multidisciplinary care and robust transition protocols for better long-term outcomes.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Public Health
Background:
- Global prevalence of inflammatory bowel disease (IBD) is increasing, with a notable rise in pediatric cases.
- Pediatric IBD often presents with distinct, more aggressive phenotypes and higher complication rates compared to adult-onset disease.
- Genetic predisposition and multifactorial pathogenesis are key considerations in pediatric IBD.
Purpose of the Study:
- To highlight the unique challenges and characteristics of pediatric-onset IBD.
- To emphasize the need for multidisciplinary management and specialized transition care protocols for pediatric IBD patients.
- To underscore the importance of tailored management strategies for optimal long-term outcomes.
Main Methods:
- Review of current literature on pediatric IBD prevalence, pathogenesis, and clinical characteristics.
- Analysis of the impact of early-onset IBD on patient development, mental health, and socio-economic factors.
- Examination of existing transition care models and their effectiveness in managing pediatric to adult IBD patient transfer.
Main Results:
- Pediatric IBD patients frequently experience mood disorders, developmental delays, and socio-economic challenges.
- Most institutions lack established transition protocols, resources, and training for effective pediatric to adult care transfer.
- Successful transition care is linked to improved remission rates, medication adherence, mental health, and academic performance.
Conclusions:
- Pediatric IBD requires a comprehensive, multidisciplinary approach extending beyond medical providers.
- Well-established transition protocols are crucial for ensuring continuity of care and improving long-term outcomes for young IBD patients.
- Management strategies must be individualized based on developmental level and environment to optimize patient well-being.
Abstract:
The prevalence of inflammatory bowel disease (IBD) continues to rise around the globe. Although the percentage of pediatric IBD patients seems to be increasing, rates are surprisingly heterogeneous among different populations. Although the pathogenesis of IBD is believed to be multifactorial, a genetic predisposition may be especially relevant in pediatric-onset IBD. Phenotypic characteristics can also be significantly different when comparing pediatric and adult-onset IBD. Patients that develop the disease at a younger age usually present with more extensive and more aggressive disease and develop complications faster when compared to those that develop it during adulthood. Children with IBD are found to have frequent mood disorders and have a higher risk of developing socio-economic hardship, failing to meet development milestones. Therefore, IBD management should always involve a multidisciplinary team that is not limited to medical providers. Most institutions do not have an established transition protocol and lack the resources and training for transition care. Although there is no consensus on an optimal timing to transition the patient's care to an adult team, it is usually accepted they should be eligible for adult care when most of the key transition points have been met. Management strategies should be tailored to each patient's developmental level and environment. A successful transition can improve the long-term outcomes such as sustained remission, medication adherence, mental health and social and academic performance, while decreasing healthcare utilization. Every institution that manages pediatric IBD patients should have a well-established transition protocol in order to make sure to maintain continuity of care.
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