Inflammatory Bowel Disease in the Baby to Baby Boomer: Pediatric and Elderly Onset of IBD

Current Treatment Options in Gastroenterology
Anita Afzali, Seymour Katz

Abstract

Early- and late-onset of inflammatory bowel disease (IBD) may perhaps be etiologically distinct and potentially attributed to genetics, environmental or microbial factors. We review disease factors and clinical characteristics, as well as unique management and treatment strategies to consider when caring for the "baby" or "baby boomer" with IBD. Around 25% of cases of initial diagnosis of IBD is made before the age of 18 years old, and another 15-20% made after the age of 60. Crohn's disease (CD) typically presents as ileocolonic and stricturing or penetrating phenotype among early-onset, whereas among late-onset, it is mainly colonic and inflammatory. Pediatric ulcerative colitis (UC) is mostly pan-colonic versus primarily left-sided among the elderly. Treatment goal for both age groups is primarily symptom control, with growth and development also considered among pediatric patients. Due to alterations in pharmacokinetics, careful monitoring and reduced dose should be considered. A multidisciplinary care team is necessary to ensure better clinical outcomes. Onset of disease at either spectrum of age requires careful management and treatment, with both unique disease- and age-appropriate factors carefully considered.

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Citations

Jan 24, 2019·Pediatric Gastroenterology, Hepatology & Nutrition·Jeongseok Kim, Byong Duk Ye
Jan 27, 2020·Techniques in Coloproctology·G PellinoUNKNOWN the Italian Society of Colorectal Surgery (SICCR)
Apr 3, 2020·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Olga Maria NardoneFabiana Castiglione
May 27, 2021·The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi·Mi Jin KimYon Ho Choe
Aug 10, 2021·Journal of Pediatric Gastroenterology and Nutrition·Martha A C van GaalenJohanna C Escher

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