Gastroenterol Hepatol. 2022 Oct 12;S0210-5705(22)00229-1.doi: 10.1016/j.gastrohep.2022.10.003. Online ahead of print.

M Constanza Bay ¹, F Paulina Núñez ², Rodrigo Quera ³, Andrés J Yarur ⁴

Author information

¹Department of Pediatrics, Hospital UC Christus Health - Pontificia Universidad Católica de Chile, Santiago, 8330024, Chile. Electronic address: constanzabaym@gmail.com.

²Department of Gastroenterology, Hospital San Juan De Dios. Universidad de Chile. Inflammatory Bowel Disease Programm, Digestive Disease Center, Clínica Universidad de los Andes. Universidad de los Andes, Santiago, 7620157, Chile. Electronic address: pnunez@clinicauandes.cl.

³Inflammatory Bowel Disease Programm, Digestive Disease Center, Clínica Universidad de los Andes. Universidad de los Andes, Santiago, 7620157, Chile.

⁴Cedars-Sinai Medical Center. Los Angeles, California, USA. 8730 Alden Dr. Thalians 2E Los Angeles, CA 90048, USA.

Abstract

The prevalence of Inflammatory bowel disease (IBD) continues to rise around the globe. Although the percentage of pediatric IBD patients seems to be increasing, rates are surprisingly heterogeneous among different populations. Although the pathogenesis of IBD is believed to be multifactorial, a genetic predisposition may be especially relevant in pediatric-onset IBD. Phenotypic characteristics can also be significantly different when comparing pediatric and adult-onset IBD. Patients that develop the disease at a younger age usually present with more extensive and more aggressive disease and develop complications faster when compared to those that develop it during adulthood. Children with IBD are found to have frequent mood disorders and have a higher risk of developing socio-economic hardship, failing to meet development milestones. Therefore, IBD management should always involve a multidisciplinary team that is not limited to medical providers. Most institutions do not have an established transition protocol and lack the resources and training for transition care. Although there is no consensus on an optimal timing to transition the patient's care to an adult team, it is usually accepted they should be eligible for adult care when most of the key transition points have been met. Management strategies should be tailored to each patient's developmental level and environment. A successful transition can improve the long-term outcomes such as sustained remission, medication adherence, mental health and social and academic performance, while decreasing healthcare utilization. Every institution that manages pediatric IBD patients should have a well-established transition protocol in order to make sure to maintain continuity of care.