PEDIATRIC INFLAMMATORY BOWEL-DISEASE

Inflammatory bowel disease (IBD) in childhood and adolescence represen ts a major challenge to patients, their families, and their physicians . The onset of IBD comes at an especially vulnerable time, occurring a t ages characterized by dynamic states of growth and physical change, as well as frequent alterations in psychologic status. A significant p roportion of patients develop IBD just prior to or during puberty. Thi s review examines recurring themes in the literature on pediatric IBD with particular attention to recently published studies, Topics includ e epidemiology, genetic and immunologic influences, clinical features (emphasizing growth failure as a unique clinical presentation in pedia tric IBD), diagnosis, complications, new therapeutic modalities, diffe rential diagnosis, and social implications, To better define deviation s of growth that occur during IBD, we have also evaluated recent work highlighting long-term growth patterns in children with no known organ ic basis for short stature.