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

  • Intractable Disease in the Elderly: When Conventional Therapy Fails (S Katz, Section Editor)
  • Published:
Current Treatment Options in Gastroenterology Aims and scope Submit manuscript

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.

Summary

Onset of disease at either spectrum of age requires careful management and treatment, with both unique disease- and age-appropriate factors carefully considered.

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Authors and Affiliations

  1. The Ohio State University Inflammatory Bowel Disease Center, Columbus, OH, USA

    Anita Afzali MD, MPH, FACG

  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 MD, MPH, FACG

  3. NYU Langone Nassau Gastroenterology Associates, New York University School of Medicine, Great Neck, NY, USA

    Seymour Katz MD, FACP, MACG

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  1. Anita Afzali MD, MPH, FACG
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Afzali A: performed the research and wrote the paper. Katz S: contributed critical revision and intellectual content.

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Correspondence to Anita Afzali MD, MPH, FACG.

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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.

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This article is part of the Topical Collection on Intractable Disease in the Elderly: When Conventional Therapy Fails

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Afzali, A., Katz, S. Inflammatory Bowel Disease in the Baby to Baby Boomer: Pediatric and Elderly Onset of IBD. Curr Treat Options Gastro 16, 289–305 (2018). https://doi.org/10.1007/s11938-018-0188-9

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