Epidemiology of Pediatric Inflammatory Bowel Disease

Inflammatory bowel diseases (IBD) are chronic relapsing gastrointestinal disorders, presenting most commonly in the adolescent to young adult age. Approximately 25% of IBD occur before age 20 years, and 4% occur in younger than 5 years of age. The underlying inflammation in IBD is thought to occur as a result of immune dysregulation in response to “normal” gut flora in a genetically susceptible host with varying levels of immunoreactivity and genetic predispositions emerging as potential critical factors in the pathogenesis of IBD and disease progression. These developments have enabled us to begin to think about individualized therapy selection, restricting aggressive and more potent therapies (e.g., biologics) for the patients who have a high risk profile and limiting the exposure of toxic medications.