Inflammatory Bowel Disease in the Baby to Baby Boomer: Pediatric and Elderly Onset of IBD
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.
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.
KeywordsPediatric IBD Elderly IBD Early-onset and late-onset IBD Pediatric-adult transition of IBD care
Afzali A: performed the research and wrote the paper. Katz S: contributed critical revision and intellectual content.
Compliance with ethical standards
Conflict of interest
Anita Afzali reports grants from Abbvie and UCB; honoraria from Abbvie, UCB, Takeda, Janssen, and IBD Horizons, and payment and travel accommodations from UCB, Takeda, Abbvie, IBD Horizons and Janssen.
Seymour Katz has no conflict of interests to disclose.
Human and animal rights and informed consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
References and Recommended Reading
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