BACKGROUND: Nearly 20% of all inflammatory bowel disease (IBD) is diagnosed in children and adolescents, where it follows a more compli-cated and aggressive course than adult-onset IBD. General practitioners (GPs) have a pivotal role in early diagnosis, and monitoring and supporting children and families with IBD. OBJECTIVE: This article will focus on recognising key differences between paediatric-onset IBD and adult-onset IBD, proposed treatment targets, and practical issues in the management of adolescents with IBD. DISCUSSION: IBD in children is more aggressive in nature, with additional issues of growth failure, delayed puberty and the consequences of a chronic disease commencing at a vulnerable period of psychosocial development. Traditional treatment targets focus on symptom control, but this is insufficient as long-term, end-organ (bowel) damage results from insufficiently controlled inflammation. In this article, we provide a brief overview of IBD in adolescents and cover key management issues, particularly focusing on newer treatment end-points by aiming for high rates of intestinal mucosal healing and evidence to support this approach.
BACKGROUND: Nearly 20% of all inflammatory bowel disease (IBD) is diagnosed in children and adolescents, where it follows a more compli-cated and aggressive course than adult-onset IBD. General practitioners (GPs) have a pivotal role in early diagnosis, and monitoring and supporting children and families with IBD. OBJECTIVE: This article will focus on recognising key differences between paediatric-onset IBD and adult-onset IBD, proposed treatment targets, and practical issues in the management of adolescents with IBD. DISCUSSION: IBD in children is more aggressive in nature, with additional issues of growth failure, delayed puberty and the consequences of a chronic disease commencing at a vulnerable period of psychosocial development. Traditional treatment targets focus on symptom control, but this is insufficient as long-term, end-organ (bowel) damage results from insufficiently controlled inflammation. In this article, we provide a brief overview of IBD in adolescents and cover key management issues, particularly focusing on newer treatment end-points by aiming for high rates of intestinal mucosal healing and evidence to support this approach.
Authors: Airton Pereira E Silva; João R A Soares; Erika Bertozzi de Aquino Mattos; Claudia Josetti; Isabelle M Guimarães; Sylvia M N Campos; Gerlinde A P B Teixeira Journal: Int J Exp Pathol Date: 2018-09-02 Impact factor: 1.925