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Crohn’s and colitis in children and adolescents

World Journal of Gastroenterology 2012年第41期18卷 5862-5869页

作者： Andrew S Day oren ledder Steven T Leach Daniel A Lemberg Department of Gastroenterology Sydney Children's HospitalRandwickSydneyNSW 2031Australia School of Women's and Children's Health University of New South WalesSydneyNSW 2031Australia Department of Paediatrics University of Otago ChristchurchChristchurch 8140New Zealand

Crohn＇s disease and ulcerative colitis can be grouped as the inflammatory bowel diseases （IBD）. These conditions have become increasingly common in recent years, including in children and young people. Although much is known about aspects of the pathogenesis of these diseases, the precise aetiology is not yet understood, and there remains no cure. Recent data has illustrated the importance of a number of genes-several of these are important in the onset of IBD in early life, including in infancy. Pain, diarrhoea and weight loss are typical symptoms of paediatric Crohn＇s disease whereas bloody diarrhoea is more typical of colitis in children. However, atypical symptoms may occur in both conditions： these include isolated impairment of linear growth or presentation with extra-intestinal manifestations such as erythma nodosum. Growth and nutrition are commonly compromised at diagnosis in both Crohn＇s disease and colitis. Consideration of possible IBD and completion of appropriate investigations are essential to ensure prompt diagnosis, the- reby avoiding the consequences of diagnostic delay. Patterns of disease including location and progression of IBD in childhood differ substantially from adult- onset disease. Various treatment options are available for children and adolescents with IBD. Exclusive enteral nutrition plays a central role in the induction of remission of active Crohn＇s disease. Medical and surgical therapies need to considered within the context of a growing and developing child. The overall management of these chronic conditions in children should include multi-disciplinary expertise, with focus upon maintaining control of gut inflammation, optimising nutrition, growth and quality of life, whilst preventing disease or treatment-related complications.

关键词： Children Adolescents Crohn's disease Ulcerative colitis Inflammatory bowel diseases

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