Inflammatory bowel disease

Inflammatory bowel disease (IBD) describes a heterogeneous group of chronic inflammatory diseases of the gastrointestinal tract, of which Crohn’s disease and ulcerative colitis are the most common diagnoses. About a quarter of IBD presents in childhood, and the phenotype seen involves a wider disease distribution in both Crohn’s and ulcerative colitis than seen in adult-onset disease. The incidence of IBD appears to be rising and although we understand more about the genetic, immunological and environmental contributors to aetiology, we do not yet fully understand this rise. In paediatric practice, IBD and in particular Crohn’s disease, often results in impaired weight gain, poor linear growth and delayed puberty. Multiple treatment modalities exist for IBD from longstanding treatments such as steroids and immunosuppressants to modern, targeted therapies such as infliximab. This review discusses the current state of the art of clinical practice in relation to paediatric IBD.