Update on paediatric inflammatory bowel disease

Abstract 

Inflammatory bowel disease in children is more prevalent than previously realized. Recent studies suggest an incidence in the UK of 5.3 per 100,000 in children under the age of 16 years, equivalent to around 700 new cases per annum, with Crohn's disease (CD) being at least twice as common as ulcerative colitis. The diseases appear to have a polygenic basis, with environmental factors providing the trigger of clinical disease in susceptible individuals. Endoscopy is vital for diagnosis, and new treatment modalities include the use of enteral nutrition as the sole therapy to induce and maintain remission, and the increasing early use of immunomodulatory agents such as azathioprine as steroid-sparing agents. Carefully timed, surgery is still important in both the acute and the chronic situation, particularly in the latter regard when growth faltering has not responded to medical therapy. Closer co-operation between specialist centres in the UK will hopefully provide an opportunity to conduct worthwhile multicentre research, in order to help tackle the many questions that still require a definite answer.

Keywords: inflammatory bowel disease, Crohn's disease, ulcerative colitis, enteral nutrition

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• f1 E-mail: huw.jenkins@uhw-tr.wales.nhs.uk