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Curr Treat Options Gastroenterol. 2018 Sep;16(3):289-305. doi: 10.1007/s11938-018-0188-9.

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

Author information

1
The Ohio State University Inflammatory Bowel Disease Center, Columbus, OH, USA. anita.afzali@osumc.edu.
2
Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, 395 West 12th Avenue Room 280, Columbus, OH, 43210, USA. anita.afzali@osumc.edu.
3
NYU Langone Nassau Gastroenterology Associates, New York University School of Medicine, Great Neck, NY, USA.

Abstract

PURPOSE OF REVIEW:

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.

RECENT FINDINGS:

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.

KEYWORDS:

Early-onset and late-onset IBD; Elderly IBD; Pediatric IBD; Pediatric-adult transition of IBD care

PMID:
30006766
DOI:
10.1007/s11938-018-0188-9

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