Current Treatment Options in Gastroenterology

, Volume 16, Issue 3, pp 289–305 | Cite as

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

  • Anita AfzaliEmail author
  • Seymour Katz
Intractable Disease in the Elderly: When Conventional Therapy Fails (S Katz, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Intractable Disease in the Elderly: When Conventional Therapy Fails


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.


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


Pediatric IBD Elderly IBD Early-onset and late-onset IBD Pediatric-adult transition of IBD care 


Author contributions

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

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.The Ohio State University Inflammatory Bowel Disease CenterColumbusUSA
  2. 2.Division of Gastroenterology, Hepatology, and NutritionThe Ohio State University Wexner Medical CenterColumbusUSA
  3. 3.NYU Langone Nassau Gastroenterology AssociatesNew York University School of MedicineGreat NeckUSA

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