Epidemiology and environmental factors in inflammatory bowel disease in children and adolescents
- Leslie M Higuchi, MD, MPH
Leslie M Higuchi, MD, MPH
- Instructor in Pediatrics
- Harvard Medical School
- Athos Bousvaros, MD
Athos Bousvaros, MD
- Associate Professor of Pediatrics
- Harvard Medical School
Inflammatory bowel disease (IBD) is comprised of two major disorders: ulcerative colitis (UC) and Crohn disease (CD). UC affects the colon, whereas CD can involve any component of the gastrointestinal tract from the oral cavity to the anus. These disorders have distinct pathologic and clinical characteristics, but their pathogenesis remains poorly understood. (See "Immune and microbial mechanisms in the pathogenesis of inflammatory bowel disease".)
The peak incidence of IBD occurs in patients between the ages of 15 and 30 years [1,2]. Approximately 20 percent of patients with CD and 12 percent of patients with UC develop their IBD before the age of 20 years . Both adults and children with IBD may present with similar clinical features; however, children can develop unique complications, including growth failure and delayed puberty. Clinicians caring for children and adolescents with one of these disorders must treat the underlying disease and its complications and must also carefully monitor linear growth, skeletal development, and puberty.
The epidemiology and role of environmental factors in IBD in children and adolescents will be reviewed here. The clinical manifestations, diagnosis, and treatment of CD and UC in children and adolescents and the role of genetic factors are presented in separate topic reviews:
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