Health Supervision in the Management of Children and Adolescents With IBD: NASPGHAN Recommendations

• Published in: Journal of pediatric gastroenterology and nutrition Vol. 55; no. 1; pp. 93 - 108
• Main Authors: Rufo, Paul A, Denson, Lee A, Sylvester, Francisco A, Szigethy, Eva, Sathya, Pushpa, Lu, Ying, Wahbeh, Ghassan T, Sena, Laureen M, Faubion, William A
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Copyright by ESPGHAN and NASPGHAN 01.07.2012; Lippincott Williams & Wilkins
• Subjects: Adolescent; Biological and medical sciences; Calcium, Dietary; Child; Child, Preschool; Colitis, Ulcerative - diagnosis; Colitis, Ulcerative - drug therapy; Colitis, Ulcerative - psychology; Crohn Disease - diagnosis; Crohn Disease - drug therapy; Crohn Disease - psychology; Diet; Dietary Supplements; Early Detection of Cancer; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Immunization; Immunosuppressive Agents - therapeutic use; Infant; Infant, Newborn; Male; Medical History Taking; Medical sciences; Nutrition Assessment; Other diseases. Semiology; Physical Examination; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumor Necrosis Factor-alpha - antagonists & inhibitors; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vitamin D - blood; Vitamin D - therapeutic use; Human; Metabolic diseases; Recommendation; Care; Inflammatory disease; Prevention; Inflammatory bowel disease; Crohn disease; preventive care; Adolescent; Gastroenterology; Digestive diseases; Intestinal disease; primary care; Child; health supervision; Ulcerative colitis
• ISSN: 0277-2116; 1536-4801
• DOI: 10.1097/MPG.0b013e31825959b8

ABSTRACTUlcerative colitis (UC) and Crohn disease (CD), collectively referred to as inflammatory bowel disease (IBD), are chronic inflammatory disorders that can affect the gastrointestinal tract of children and adults. Like other autoimmune processes, the cause(s) of these disorders remain unknown but likely involves some interplay between genetic vulnerability and environmental factors. Children, in particular with UC or CD, can present to their primary care providers with similar symptoms, including abdominal pain, diarrhea, weight loss, and bloody stool. Although UC and CD are more predominant in adults, epidemiologic studies have demonstrated that a significant percentage of these patients were diagnosed during childhood. The chronic nature of the inflammatory process observed in these children and the waxing and waning nature of their clinical symptoms can be especially disruptive to their physical, social, and academic development. As such, physicians caring for children must consider these diseases when evaluating patients with compatible symptoms. Recent research efforts have made available a variety of more specific and effective pharmacologic agents and improved endoscopic and radiologic assessment tools to assist clinicians in the diagnosis and interval assessment of their patients with IBD; however, as the level of complexity of these interventions has increased, so too has the need for practitioners to become familiar with a wider array of treatments and the risks and benefits of particular diagnostic testing. Nonetheless, in most cases, and especially when frequent visits to subspecialty referral centers are not geographically feasible, primary care providers can be active participants in the management of their pediatric patients with IBD. The goal of this article is to educate and assist pediatricians and adult gastroenterology physicians caring for children with IBD, and in doing so, help to develop more collaborative care plans between primary care and subspecialty providers.