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The Natural History of Crohn Disease in Children

  • Benjamin SahnEmail author
  • James Markowitz
Chapter

Abstract

There are many factors that determine the natural history of Crohn disease. Considerations include disease activity over time, evolution from an inflammatory phenotype to fibrostenotic or penetrating disease, development of corticosteroid dependence, need for surgery, and disease recurrence following bowel resection. Factors that are unique in the pediatric patient include disturbances of growth and development and differences in childhood quality of life measures. The impact of genotypic variants on phenotypic expression over time is only beginning to be elucidated. Without long-term data on untreated patients or placebo-controlled studies in children to draw upon, the true natural history of pediatric Crohn disease is left to be approximated by the disease course in individuals treated only with corticosteroid and/or mesalamine. With an evolving armamentarium of medical therapies available, altering the natural history to prevent complications related to both the disease and chronic corticosteroid exposure has become one of the primary targets of therapy today.

Keywords

Crohn disease Natural history Disease activity Disease evolution Growth Corticosteroid dependence Postoperative recurrence Quality of life 

Abbreviations

Anti-TNF

Antitumor necrosis factor alpha

CD

Crohn disease

ECCDS

European Cooperative Crohn’s Disease Study

HRQOL

Health-related quality of life

IBD

Inflammatory bowel disease

NCCDS

National Cooperative Crohn’s Disease Study

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Hofstra Northwell School of MedicineHempsteadUSA
  2. 2.Division of Pediatric Gastroenterology and NutritionSteven and Alexandra Cohen Children’s Medical Center of NY, Northwell HealthNew Hyde ParkUSA

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