Inflammatory Bowel Disease-An Updated Review From Pediatrics Aspects.

Abstract

Background: Inflammatory bowel disease (IBD) is a chronic, immune-mediated condition primarily targeting the gastrointestinal tract. It includes two main subtypes: Crohn's disease (CD) and ulcerative colitis (UC). Pediatric IBD (PIBD) incidence has risen significantly over the past decades, particularly in regions with historically low prevalence. These conditions involve complex interactions among genetic predisposition, gut microbiota, immune dysregulation, and environmental factors.

Aim: This review examines the latest advances in the diagnosis, treatment, and management of PIBD, emphasizing distinct challenges in pediatric cases compared to adult-onset IBD.

Methods: This updated review synthesizes evidence from recent studies and clinical guidelines on PIBD, focusing on diagnostic approaches, treatment modalities, and evolving therapeutic strategies. Particular emphasis is placed on biologic therapies, dietary interventions, and the differentiation of PIBD from other gastrointestinal disorders.

Results: Early diagnosis of PIBD remains critical to minimizing complications. While traditional therapies, such as corticosteroids and exclusive enteral nutrition (EEN), induce remission, biologics like anti-TNF agents and emerging therapies (e.g., anti-IL-12/IL-23 agents and fecal microbiota transplantation) demonstrate enhanced efficacy. Biologics are tailored based on disease severity and patient profiles, with therapeutic drug monitoring (TDM) optimizing outcomes. New diagnostic tools, such as fecal calprotectin, offer noninvasive methods for early detection. Emerging exclusion diets and microbiota-focused approaches hold promise for improved outcomes in PIBD management.

Conclusion: PIBD requires tailored management strategies distinct from adult-onset IBD due to its unique disease course, including growth impairment and prolonged inflammatory damage. Advances in biologic therapies, dietary interventions, and diagnostic tools have improved treatment efficacy and patient quality of life. Early intervention, personalized therapies, and ongoing research into emerging modalities are vital for enhancing long-term outcomes.