0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Review |

Inflammatory Bowel Disease in Children and Adolescents

Michael J. Rosen, MD, MSCI1,2; Ashish Dhawan, MBBS, MSPH1,2; Shehzad A. Saeed, MD1,2
[+] Author Affiliations
1Schubert-Martin Inflammatory Bowel Disease Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
2Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
JAMA Pediatr. 2015;169(11):1053-1060. doi:10.1001/jamapediatrics.2015.1982.
Text Size: A A A
Published online

The inflammatory bowel diseases (IBDs), including ulcerative colitis and Crohn disease, are chronic inflammatory disorders of the gastrointestinal tract most often diagnosed in adolescence and young adulthood, with a rising incidence in pediatric populations. These disorders are common enough in children that most pediatricians and other pediatric clinicians will encounter children with IBD in their general practice. Inflammatory bowel disease is caused by a dysregulated mucosal immune response to the intestinal microflora in genetically predisposed hosts. Although children can present with the classic symptoms of weight loss, abdominal pain, and bloody diarrhea, many present with nonclassic symptoms of isolated poor growth, anemia, or other extraintestinal manifestations. Once IBD is diagnosed, the goals of therapy consist of eliminating symptoms, normalizing quality of life, restoring growth, and preventing complications while minimizing the adverse effects of medications. Unique considerations when treating children and adolescents with IBD include attention to the effects of the disease on growth and development, bone health, and psychosocial functioning. The purpose of this review is to provide a contemporary overview of the epidemiologic features, pathogenesis, diagnosis, and management of IBD in children and adolescents.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Figures

Place holder to copy figure label and caption
Figure.
Representative Endoscopic Images of Normal and Inflamed Gastrointestinal Mucosa From Pediatric Patients With and Without Inflammatory Bowel Disease

A, A vascular pattern, villous epithelium, and normal lymphoid nodularity are visible. B, A thin transparent glistening mucosa and delicate vascular network are visible. C, Terminal ileum in a child with Crohn disease (CD) shows mucosal thickening and erythema, complete loss of vascular pattern, pseudopolyps surrounded by deep ulceration, and luminal narrowing. D, Linear ulcer directly adjacent to normal colon mucosa in a young child with CD. E, Tissue in the stomach antrum of a 10-year-old child with CD. F, An adolescent with ulcerative colitis has diffuse erythema, loss of vascular pattern, and granular-appearing superficial ulceration.

Graphic Jump Location

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

3,370 Views
2 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed
Are the Results Valid?

Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed
Are There Important Aspects of Health-Related Quality of Life That Have Been Omitted?

brightcove.createExperiences();