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Current Treatment Options in Gastroenterology
Published in: Current Treatment Options in Gastroenterology 3/2018

01-09-2018 | Intractable Disease in the Elderly: When Conventional Therapy Fails (S Katz, Section Editor)

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

Authors: Anita Afzali, MD, MPH, FACG, Seymour Katz, MD, FACP, MACG

Published in: Current Treatment Options in Gastroenterology | Issue 3/2018

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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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Metadata
Title
Inflammatory Bowel Disease in the Baby to Baby Boomer: Pediatric and Elderly Onset of IBD
Authors
Anita Afzali, MD, MPH, FACG
Seymour Katz, MD, FACP, MACG
Publication date
01-09-2018
Publisher
Springer US
Published in
Current Treatment Options in Gastroenterology / Issue 3/2018
Print ISSN: 1092-8472
Electronic ISSN: 1534-309X
DOI
https://doi.org/10.1007/s11938-018-0188-9

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