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Crohn's and colitis in children and adolescents

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Crohn's disease and ulcerative colitis can be grouped as the inflammatory bowel diseases (IBD).These conditions have become increasingly common in recent years,including in children and young people.Although much is known about aspects of the pathogenesis of these diseases,the precise aetiology is not yet understood,and there remains no cure.Recent data has illustrated the importance of a number of genes-several of these are important in the onset of IBD in early life,including in infancy.Pain,diarrhoea and weight loss are typical symptoms of paediatric Crohn's disease whereas bloody diarrhoea is more typical of colitis in children.However,atypical symptoms may occur in both conditions:these include isolated impairment of linear growth or presentation with extra-intestinal manifestations such as erythèma nodosum.Growth and nutrition are commonly compromised at diagnosis in both Crohn's disease and colitis.Consideration of possible IBD and completion of appropriate investigations are essential to ensure prompt diagnosis,thereby avoiding the consequences of diagnostic delay.Patterns of disease including location and progression of IBD in childhood differ substantially from adultonset disease.Various treatment options are available for children and adolescents with IBD.Exclusive enteral nutrition plays a central role in the induction of remission of active Crohn's disease.Medical and surgical therapies need to considered within the context of a growing and developing child.The overall management of these chronic conditions in children should include multi-disciplinary expertise,with focus upon maintaining control of gut inflammation,optimising nutrition,growth and quality of life,whilst preventing disease or treatment-related complications.

ChildrenAdolescentsCrohn's diseaseUlcerative colitisInflammatory bowel diseases

Andrew S Day、Oren Ledder、Steven T Leach、Daniel A Lemberg

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Department of Gastroenterology, Sydney Children's Hospital, Randwick,Sydney, NSW 2031, Australia

School of Women's and Children's Health, University of New South Wales, Sydney, NSW 2031, Australia

Department of Paediatrics, University of Otago Christchurch, Christchurch 8140, New Zealand

2012

10.3748/wjg.v18.i41.5862

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子：1.001
ISSN：1007-9327
年,卷(期)：2012.18(41)
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