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Related Concept Videos

Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

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Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
327
Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

507
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
507
Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

250
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
250
Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

182
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
182
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy

381
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
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Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

165
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
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Infantile-onset inflammatory bowel disease has variable long-term outcomes.

Alex Krauthammer1,2, Ilana Weintraub1, Ron Shaoul3

  • 1Pediatric Gastroenterology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel hashomer, Israel.

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|March 20, 2023
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Summary

Infantile-onset inflammatory bowel disease (IO-IBD) often presents severely but most children achieve long-term remission. Early diagnosis and management are crucial due to a high initial surgery rate in these young patients.

Keywords:
infantile onsetinflammatory bowel diseaselong-term outcomeremissionsurgery

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Area of Science:

  • Pediatric Gastroenterology
  • Inflammatory Bowel Disease Research
  • Clinical Outcomes

Background:

  • Infantile-onset inflammatory bowel disease (IO-IBD), diagnosed under age 2, is typically more severe and treatment-resistant.
  • Limited data exists on the long-term prognosis and management of IO-IBD.
  • Understanding IO-IBD's trajectory is vital for improving patient care.

Purpose of the Study:

  • To evaluate the clinical presentation and long-term outcomes of patients with IO-IBD.
  • To analyze disease characteristics, treatment responses, and remission rates in a cohort of young IBD patients.
  • To provide insights into the management of severe early-onset IBD.

Main Methods:

  • Retrospective multicenter study reviewing medical records of 23 patients diagnosed with IO-IBD (2000-2017).
  • Data collected included demographics, disease phenotype, location, surgical history, medical therapies, and comorbidities.
  • Minimum 1-year follow-up was required for inclusion.

Main Results:

  • Most patients (73%) achieved long-term remission, with some off medication or on 5-ASA alone.
  • High initial rates of corticosteroid use (87%) and surgery (26% ileostomy at diagnosis) were observed.
  • Follow-up duration was a median of 51.2 months.

Conclusions:

  • Despite severe initial presentation, the majority of IO-IBD patients achieve long-term remission.
  • High rates of surgery, particularly early in the disease course, necessitate careful management strategies.
  • This study highlights the potential for favorable long-term outcomes with appropriate interventions.