Challenges and progress in pediatric inflammatory bowel disease.

PURPOSE OF REVIEW: The induction and maintenance of disease remission and prevention of complications are primary goals in the management of inflammatory bowel disease. Recent research has added new insights into the pathogenesis, epidemiology, and treatment options for children with inflammatory bowel disease, and the findings will enable clinicians to develop a more rational approach to the diagnosis and treatment of pediatric patients with ulcerative colitis and Crohn's disease.

RECENT FINDINGS: Population-based studies have confirmed the increased incidence of inflammatory bowel disease in children. Previous medical history and serologies can be predictive of complications in Crohn's disease. Newer radiological and capsule endoscopic modalities have a potential future role in the diagnosis and interval assessment of patients with inflammatory bowel disease. Biological therapies play an increasingly prominent role in the management of children with ulcerative colitis and Crohn's disease. Studies of children with inflammatory bowel disease suggest that behavioral interventions may have a positive impact on morbidity and overall quality of life.

SUMMARY: New information concerning the natural history of Crohn's disease and ulcerative colitis and a better understanding of different treatment modalities will enable the development of increasingly effective and individualized pharmacological treatment plans for children with inflammatory bowel disease.