Current Gastroenterology Reports

, Volume 14, Issue 2, pp 166–173

Medical Therapy for Pediatric Inflammatory Bowel Disease

Inflammatory Bowel Disease (SB Hanauer, Section Editor)

Abstract

Pediatric inflammatory bowel disease encompasses a spectrum of disease phenotype, severity, and responsiveness to treatment. Intestinal healing rather than merely symptom control is an especially important therapeutic goal in young patients, given the potential for growth impairment as a direct effect of persistent chronic inflammation and the long life ahead, during which other disease complications may occur. Corticosteroids achieve rapid symptom control, but alternate steroid-sparing strategies with greater potential to heal the intestine must be rapidly adopted. Exclusive enteral nutrition is an alternate short-term treatment in pediatric Crohn’s disease. The results of multi-center pediatric clinical trials of both infliximab and adalimumab in Crohn’s disease and of infliximab in ulcerative colitis (all in children with unsatisfactory responses to other therapies) have now been reported and guide treatment regimens in clinical practice. Optimal patient selection and timing of anti-TNF therapy requires clinical judgment. Attention must be paid to sustaining responsiveness safely.

Keywords

Pediatric inflammatory bowel disease Inflammatory bowel disease Crohn’s disease Ulcerative colitis Pediatric Enteral nutrition Immunomodulator Biologic Infliximab Adalimumab 

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Division of GastroenterologyMcMaster Children’s HospitalHamiltonCanada
  2. 2.Division of Gastroenterology, Hepatology and NutritionThe Hospital for Sick Children, University of TorontoTorontoCanada

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