Inflammatory bowel disease in adolescents.

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.