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Mistakes in paediatric inflammatory bowel disease and how to avoid them

Neil Chanchlani, Richard K Russell

Summary

AI Generated

Approximately 1 in 10 inflammatory bowel disease cases present before adulthood, typically at age 11–12 years, with paediatric IBD characterized by more extensive and active disease than adult-onset forms.

  • IBD in children and young people is associated with more extensive disease, increased disease activity, and a higher rate of complications compared with adult-onset IBD.
  • Around 1 in 10 cases of IBD present before adulthood, with a median presentation age of 11–12 years.
  • Data suggest the incidence of paediatric IBD is increasing, though worldwide prevalence estimates are currently lacking.
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Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Ghione S, et al. Dramatic Increase in Incidence of Ulcerative Colitis and Crohn's Disease (1988-2011): A Population-Based Study of French Adolescents. Am J Gastroenterol Epub ahead of print 15 August 2017. doi: 10.1038/ajg.2017.228. [Link]
2.
Pigneur B, et al. Natural history of Crohn’s disease: comparison between childhood- and adult-onset disease. Inflamm Bowel Dis 2010; 16: 953–961. [Link]
3.
Benchimol EI, et al. Epidemiology of pediatric inflammatory bowel disease: A systematic review of international trends. Inflamm Bowel Dis 2011; 17: 423–439. [Link]
4.
Oliveira SB and Monteiro IM. Diagnosis and management of inflammatory bowel disease in children. BMJ 2017; 357: j2083. [Link]
5.
Abramson O, et al. Incidence, prevalence, and time trends of pediatric inflammatory bowel disease in Northern California, 1996 to 2006. J Pediatr 2010; 157: 233–239.e1. [Link]
6.
Fell JM, et al. Management of ulcerative colitis. Arch Dis Child 2016; 101: 469–474. [Link]
7.
Levine A, et al. ESPGHAN revised porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents. J Pediatr Gastroenterol Nutr 2014; 58: 795–806. [Link]
8.
Uhlig HH, et al. The diagnostic approach to monogenic very early onset inflammatory bowel disease. Gastroenterology 2014; 147: 990–1007.e3. [Link]
9.
Rothenberg ME. Eosinophilic gastrointestinal disorders (EGID). J Allergy Clin Immunol 2004; 113: 11–28. [Link]
10.
Boyce JA, et al. Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored expert panel report. J Am Diet Assoc 2011; 111: 17–27. [Link]
11.
Gerasimidis K, et al. The epidemiology of anemia in pediatric inflammatory bowel disease: prevalence and associated factors at diagnosis and follow-up and the impact of exclusive enteral nutrition. Inflamm Bowel Dis 2013; 19: 2411–2422. [Link]
12.
Dignass AU, et al. European consensus on the diagnosis and management of iron deficiency and anaemia in inflammatory bowel diseases. J Crohns Colitis 2015; 9: 211–222. [Link]
13.
Thayu M and Mamula P. Treatment of iron deficiency anemia in pediatric inflammatory bowel disease. Curr Treat Options Gastro 2005; 8: 411–417. [Link]
14.
Henderson P, et al. The diagnostic accuracy of fecal calprotectin during the investigation of suspected pediatric inflammatory bowel disease: a systematic review and meta-analysis. Am J Gastroenterol 2014; 109: 637–645. [Link]
15.
Zhu Q, et al. Fecal calprotectin in healthy children aged 1–4 years. PLoS One 2016; 11: e0150725. [Link]
16.
Oord T and Hornung N. Fecal calprotectin in healthy children. Scand J Clin Lab Invest 2014; 74: 254–258. [Link]
17.
Heuschkel RB, et al. Enteral nutrition and corticosteroids in the treatment of acute Crohn's disease in children. J Pediatr Gastroenterol Nutr 2000; 31: 8–15. [Link]
18.
Swaminath A, et al. Systematic review with meta-analysis: enteral nutrition therapy for the induction of remission in paediatric Crohn's disease. Aliment Pharmacol Ther 2017; 46: 645–656. [Link]
19.
Zachos M, et al. Enteral nutritional therapy for induction of remission in Crohn’s disease. Cochrane Database Syst Rev 2007; 1: CD000542. [Link]
20.
Day AS, et al. Systematic review: nutritional therapy in paediatric Crohn's disease. Aliment Pharmacol Ther 2008; 27: 293–307. [Link]
21.
Afzal NA, et al. Colonic Crohn’s disease in children does not respond well to treatment with enteral nutrition if the ileum is not involved. Dig Dis Sci 2005; 50: 1471–1475. [Link]
22.
Buchanan E, et al. The use of exclusive enteral nutrition for induction of remission in children with Crohn’s disease demonstrates that disease phenotype does not influence clinical remission. Aliment Pharmacol Ther 2009; 30: 501–507. [Link]
23.
Ruemmele FM, et al. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease. J Crohns Colitis 2014; 8: 1179–1207. [Link]
24.
Critch J, et al. Use of enteral nutrition for the control of intestinal inflammation in pediatric Crohn disease. J Pediatr Gastroenterol Nutr 2012; 54: 298–305. [Link]
25.
Ludvigsson JF, et al. Elemental versus polymeric enteral nutrition in paediatric Crohn's disease: a multicentre randomized controlled trial. Acta Paediatr 2004; 93: 327–335. [Link]
26.
Rodrigues AF, et al. Does polymeric formula improve adherence to liquid diet therapy in children with active Crohn's disease? Arch Dis Child 2007; 92: 767–770. [Link]
27.
Yamamoto T, et al. Enteral nutrition for the maintenance of remission in Crohn's disease: a systematic review. Eur J Gastroenterol Hepatol 2010; 22: 1–8. [Link]
28.
Schulman JM, et al. Maintenance of remission with partial enteral nutrition therapy in pediatric crohn's disease: a retrospective study. Can J Gastroenterol Hepatol 2017; 2017: 5873158. [Link]
29.
Akobeng AK and Thomas AG. Enteral nutrition for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev 2007; 3: CD005984. [Link]
30.
Duncan H, et al. A retrospective study showing maintenance treatment options for paediatric CD in the first year following diagnosis after induction of remission with EEN: supplemental enteral nutrition is better than nothing! BMC Gastroenterol 2014; 14: 50. [Link]
31.
Hanai H, et al. Nutritional therapy versus 6-mercaptopurine as maintenance therapy in patients with Crohn's disease. Dig Liver Dis 2012; 44: 649–654. [Link]
32.
Takagi S, et al. Effectiveness of an 'half elemental diet' as maintenance therapy for Crohn's disease: A randomized-controlled trial. Aliment Pharmacol Ther 2006; 24: 1333–1340. [Link]
33.
Guariso G and Gasparetto M. Treating children with inflammatory bowel disease: Current and new perspectives. World J Gastroenterol 2014; 23: 5469–5485. [Link]
34.
Nuffield Orthopaedic Centre NHS Trust and Oxfordshire Primary Care Trust Shared Care Protocol and Infocation for GPs. Azathioprine (paediatric), http://www.ouh.nhs.uk/oxparc/professionals/documents/AzathiaprinePAEDIATRICRheumatologysharedcareprotocolJuly11.pdf (2011, accessed 15 January 2018). [Link]
35.
Turner D, et al. Management of pediatric ulcerative colitis: joint ECCO and ESPGHAN evidence-based consensus guidelines. J Pediatr Gastroenterol Nutr 2012; 55: 340–361. [Link]
36.
Fuentes D, et al. High-dose azathioprine in children with inflammatory bowel disease. Aliment Pharmacol Ther 2003; 17: 913–921. [Link]
37.
Feagan BG and Macdonald JK. Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis. Cochrane Database Syst Rev 2012; 10: CD000543. [Link]
38.
Turner D, et al. Once- versus twice-daily mesalazine to induce remission in paediatric ulcerative colitis: a randomised controlled trial. J Crohns Colitis 2017; 11: 527–533. [Link]
39.
Levine A, et al. Mesalamine enemas for induction of remission in oral mesalamine-refractory pediatric ulcerative colitis: a prospective cohort study. J Crohns Colitis 2017; 11: 970–974. [Link]
40.
Parashette KR, et al. Infliximab therapy in pediatric Crohn's disease: a review. Clin Exp Gastroenterol 2010; 3: 57–63. [Link]
41.
de Ridder L, et al. Use of biosimilars in paediatric inflammatory bowel disease: a position statement of the ESPGHAN Paediatric IBD Porto Group. J Pediatr Gastroenterol Nutr 2015; 61: 503–508. [Link]
42.
Hyams J, et al. Induction and maintenance infliximab therapy for the treatment of moderate-to-severe Crohn's disease in children. Gastroenterology 2007; 132: 863–873. [Link]
43.
Friesen CA, et al. Safety of infliximab treatment in pediatric patients with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2004; 39: 265–259. [Link]
44.
Dupont-Lucas C, et al. Identifying patients at high risk of loss of response to infliximab maintenance therapy in paediatric Crohn's Disease. J Crohns Colitis 2016; 10: 795–804. [Link]
45.
De Bie CI, et al. The duration of effect of infliximab maintenance treatment in paediatric Crohn's disease is limited. Aliment Pharmacol Ther 2011; 33: 243–250. [Link]
46.
Baert F, et al. Influence of immunogenicity on the long-term efficacy of infliximab in Crohn's disease. N Engl J Med 2003; 348: 601–608. [Link]
47.
Lichtenstein L, et al. Infliximab-related infusion reactions: systematic review. J Crohns Colitis 2015; 9: 806–815. [Link]
48.
Miele E, et al. Human antichimeric antibody in children and young adults with inflammatory bowel disease receiving infliximab. J Pediatr Gastroenterol Nutr 2004; 38: 502–508. [Link]
49.
Kirschner BS and Rich BH. Puberty and pediatric-onset inflammatory bowel disease. In: Mamula P, Markowitz JE and Baldassano RN (eds) Pediatric Inflammatory Bowel Diseases. New York: Springer; 2008. pp 133–139.
50.
Abraham BP, et al. Natural history of pediatric-onset inflammatory bowel disease: a systematic review. J Clin Gastroenterol 2012; 46: 581–589. [Link]
51.
Heuschkel R, et al. Guidelines for the management of growth failure in childhood inflammatory bowel disease. Inflamm Bowel Dis 2008; 14: 839–849. [Link]
52.
Sawczenko A, et al. Adult height in patients with early onset of Crohn’s disease. Gut 2003; 52: 454–455. [Link]
53.
Grover Z and Lewindon P. Two-year outcomes after exlcusive early enteral nutrition inductions are superior to corticosteroids in pediatric Crohn’s disease treated early with thiopurines. Dig Dis Sci 2015; 60: 3069–3074. [Link]
54.
Day AS and Lopez RN. Exclusive enteral nutrition in children with Crohn’s diease. World J Gastroenterol 2015; 21: 6809–6816. [Link]
55.
Church PC, et al. Infliximab maintains durable response and facilitates catch-up growth in luminal pediatricCrohn's disease. Inflamm Bowel Dis 2014; 20: 1177–1186. [Link]
56.
Malik S, et al. Growth in children receiving contemporary disease specific therapy for Crohn's disease. Arch Dis Child 2012; 97: 698–703. [Link]
57.
Malik S, et al. The effects of anti-TNF-α treatment with adalimumab on growth in children with Crohn's disease (CD). J Crohns Colitis 2012; 6: 337–344. [Link]
58.
Hojsak I, et al. Long-term outcomes after elective ileocecal resection in children with active localized Crohn's disease—a multicenter European study. J Pediatr Surg 2015; 50: 1630–1635. [Link]

Abstract

Around 1 in 10 cases of inflammatory bowel disease (IBD) will present before adulthood, with the median age at presentation being 11–12 years. IBD in children and young people is associated with more extensive disease, increased disease activity and a higher rate of complications compared with adult-onset IBD. Worldwide, estimates of paediatric IBD prevalence rates are lacking, but data suggest its incidence is increasing.

Topics

IBD Paediatrics

Citation

Chanchlani N. and Russell R.K. Mistakes in paediatric inflammatory bowel disease and how to avoid them. UEG Education 2018; 18: 1–6.

Published

2018

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UEG Mistakes In Articles
Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Log in to continue.

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Log In Create a free account

Not sure what you can access? Learn more about account types.

Mistakes in faecal incontinence management and how to avoid them

Kestutis Adamonis, Sadé L Assmann, Stéphanie O Breukink

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Ghione S, et al. Dramatic Increase in Incidence of Ulcerative Colitis and Crohn's Disease (1988-2011): A Population-Based Study of French Adolescents. Am J Gastroenterol Epub ahead of print 15 August 2017. doi: 10.1038/ajg.2017.228. [Link]
2.
Pigneur B, et al. Natural history of Crohn’s disease: comparison between childhood- and adult-onset disease. Inflamm Bowel Dis 2010; 16: 953–961. [Link]
3.
Benchimol EI, et al. Epidemiology of pediatric inflammatory bowel disease: A systematic review of international trends. Inflamm Bowel Dis 2011; 17: 423–439. [Link]
4.
Oliveira SB and Monteiro IM. Diagnosis and management of inflammatory bowel disease in children. BMJ 2017; 357: j2083. [Link]
5.
Abramson O, et al. Incidence, prevalence, and time trends of pediatric inflammatory bowel disease in Northern California, 1996 to 2006. J Pediatr 2010; 157: 233–239.e1. [Link]
6.
Fell JM, et al. Management of ulcerative colitis. Arch Dis Child 2016; 101: 469–474. [Link]
7.
Levine A, et al. ESPGHAN revised porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents. J Pediatr Gastroenterol Nutr 2014; 58: 795–806. [Link]
8.
Uhlig HH, et al. The diagnostic approach to monogenic very early onset inflammatory bowel disease. Gastroenterology 2014; 147: 990–1007.e3. [Link]
9.
Rothenberg ME. Eosinophilic gastrointestinal disorders (EGID). J Allergy Clin Immunol 2004; 113: 11–28. [Link]
10.
Boyce JA, et al. Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored expert panel report. J Am Diet Assoc 2011; 111: 17–27. [Link]
11.
Gerasimidis K, et al. The epidemiology of anemia in pediatric inflammatory bowel disease: prevalence and associated factors at diagnosis and follow-up and the impact of exclusive enteral nutrition. Inflamm Bowel Dis 2013; 19: 2411–2422. [Link]
12.
Dignass AU, et al. European consensus on the diagnosis and management of iron deficiency and anaemia in inflammatory bowel diseases. J Crohns Colitis 2015; 9: 211–222. [Link]
13.
Thayu M and Mamula P. Treatment of iron deficiency anemia in pediatric inflammatory bowel disease. Curr Treat Options Gastro 2005; 8: 411–417. [Link]
14.
Henderson P, et al. The diagnostic accuracy of fecal calprotectin during the investigation of suspected pediatric inflammatory bowel disease: a systematic review and meta-analysis. Am J Gastroenterol 2014; 109: 637–645. [Link]
15.
Zhu Q, et al. Fecal calprotectin in healthy children aged 1–4 years. PLoS One 2016; 11: e0150725. [Link]
16.
Oord T and Hornung N. Fecal calprotectin in healthy children. Scand J Clin Lab Invest 2014; 74: 254–258. [Link]
17.
Heuschkel RB, et al. Enteral nutrition and corticosteroids in the treatment of acute Crohn's disease in children. J Pediatr Gastroenterol Nutr 2000; 31: 8–15. [Link]
18.
Swaminath A, et al. Systematic review with meta-analysis: enteral nutrition therapy for the induction of remission in paediatric Crohn's disease. Aliment Pharmacol Ther 2017; 46: 645–656. [Link]
19.
Zachos M, et al. Enteral nutritional therapy for induction of remission in Crohn’s disease. Cochrane Database Syst Rev 2007; 1: CD000542. [Link]
20.
Day AS, et al. Systematic review: nutritional therapy in paediatric Crohn's disease. Aliment Pharmacol Ther 2008; 27: 293–307. [Link]
21.
Afzal NA, et al. Colonic Crohn’s disease in children does not respond well to treatment with enteral nutrition if the ileum is not involved. Dig Dis Sci 2005; 50: 1471–1475. [Link]
22.
Buchanan E, et al. The use of exclusive enteral nutrition for induction of remission in children with Crohn’s disease demonstrates that disease phenotype does not influence clinical remission. Aliment Pharmacol Ther 2009; 30: 501–507. [Link]
23.
Ruemmele FM, et al. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease. J Crohns Colitis 2014; 8: 1179–1207. [Link]
24.
Critch J, et al. Use of enteral nutrition for the control of intestinal inflammation in pediatric Crohn disease. J Pediatr Gastroenterol Nutr 2012; 54: 298–305. [Link]
25.
Ludvigsson JF, et al. Elemental versus polymeric enteral nutrition in paediatric Crohn's disease: a multicentre randomized controlled trial. Acta Paediatr 2004; 93: 327–335. [Link]
26.
Rodrigues AF, et al. Does polymeric formula improve adherence to liquid diet therapy in children with active Crohn's disease? Arch Dis Child 2007; 92: 767–770. [Link]
27.
Yamamoto T, et al. Enteral nutrition for the maintenance of remission in Crohn's disease: a systematic review. Eur J Gastroenterol Hepatol 2010; 22: 1–8. [Link]
28.
Schulman JM, et al. Maintenance of remission with partial enteral nutrition therapy in pediatric crohn's disease: a retrospective study. Can J Gastroenterol Hepatol 2017; 2017: 5873158. [Link]
29.
Akobeng AK and Thomas AG. Enteral nutrition for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev 2007; 3: CD005984. [Link]
30.
Duncan H, et al. A retrospective study showing maintenance treatment options for paediatric CD in the first year following diagnosis after induction of remission with EEN: supplemental enteral nutrition is better than nothing! BMC Gastroenterol 2014; 14: 50. [Link]
31.
Hanai H, et al. Nutritional therapy versus 6-mercaptopurine as maintenance therapy in patients with Crohn's disease. Dig Liver Dis 2012; 44: 649–654. [Link]
32.
Takagi S, et al. Effectiveness of an 'half elemental diet' as maintenance therapy for Crohn's disease: A randomized-controlled trial. Aliment Pharmacol Ther 2006; 24: 1333–1340. [Link]
33.
Guariso G and Gasparetto M. Treating children with inflammatory bowel disease: Current and new perspectives. World J Gastroenterol 2014; 23: 5469–5485. [Link]
34.
Nuffield Orthopaedic Centre NHS Trust and Oxfordshire Primary Care Trust Shared Care Protocol and Infocation for GPs. Azathioprine (paediatric), http://www.ouh.nhs.uk/oxparc/professionals/documents/AzathiaprinePAEDIATRICRheumatologysharedcareprotocolJuly11.pdf (2011, accessed 15 January 2018). [Link]
35.
Turner D, et al. Management of pediatric ulcerative colitis: joint ECCO and ESPGHAN evidence-based consensus guidelines. J Pediatr Gastroenterol Nutr 2012; 55: 340–361. [Link]
36.
Fuentes D, et al. High-dose azathioprine in children with inflammatory bowel disease. Aliment Pharmacol Ther 2003; 17: 913–921. [Link]
37.
Feagan BG and Macdonald JK. Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis. Cochrane Database Syst Rev 2012; 10: CD000543. [Link]
38.
Turner D, et al. Once- versus twice-daily mesalazine to induce remission in paediatric ulcerative colitis: a randomised controlled trial. J Crohns Colitis 2017; 11: 527–533. [Link]
39.
Levine A, et al. Mesalamine enemas for induction of remission in oral mesalamine-refractory pediatric ulcerative colitis: a prospective cohort study. J Crohns Colitis 2017; 11: 970–974. [Link]
40.
Parashette KR, et al. Infliximab therapy in pediatric Crohn's disease: a review. Clin Exp Gastroenterol 2010; 3: 57–63. [Link]
41.
de Ridder L, et al. Use of biosimilars in paediatric inflammatory bowel disease: a position statement of the ESPGHAN Paediatric IBD Porto Group. J Pediatr Gastroenterol Nutr 2015; 61: 503–508. [Link]
42.
Hyams J, et al. Induction and maintenance infliximab therapy for the treatment of moderate-to-severe Crohn's disease in children. Gastroenterology 2007; 132: 863–873. [Link]
43.
Friesen CA, et al. Safety of infliximab treatment in pediatric patients with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2004; 39: 265–259. [Link]
44.
Dupont-Lucas C, et al. Identifying patients at high risk of loss of response to infliximab maintenance therapy in paediatric Crohn's Disease. J Crohns Colitis 2016; 10: 795–804. [Link]
45.
De Bie CI, et al. The duration of effect of infliximab maintenance treatment in paediatric Crohn's disease is limited. Aliment Pharmacol Ther 2011; 33: 243–250. [Link]
46.
Baert F, et al. Influence of immunogenicity on the long-term efficacy of infliximab in Crohn's disease. N Engl J Med 2003; 348: 601–608. [Link]
47.
Lichtenstein L, et al. Infliximab-related infusion reactions: systematic review. J Crohns Colitis 2015; 9: 806–815. [Link]
48.
Miele E, et al. Human antichimeric antibody in children and young adults with inflammatory bowel disease receiving infliximab. J Pediatr Gastroenterol Nutr 2004; 38: 502–508. [Link]
49.
Kirschner BS and Rich BH. Puberty and pediatric-onset inflammatory bowel disease. In: Mamula P, Markowitz JE and Baldassano RN (eds) Pediatric Inflammatory Bowel Diseases. New York: Springer; 2008. pp 133–139.
50.
Abraham BP, et al. Natural history of pediatric-onset inflammatory bowel disease: a systematic review. J Clin Gastroenterol 2012; 46: 581–589. [Link]
51.
Heuschkel R, et al. Guidelines for the management of growth failure in childhood inflammatory bowel disease. Inflamm Bowel Dis 2008; 14: 839–849. [Link]
52.
Sawczenko A, et al. Adult height in patients with early onset of Crohn’s disease. Gut 2003; 52: 454–455. [Link]
53.
Grover Z and Lewindon P. Two-year outcomes after exlcusive early enteral nutrition inductions are superior to corticosteroids in pediatric Crohn’s disease treated early with thiopurines. Dig Dis Sci 2015; 60: 3069–3074. [Link]
54.
Day AS and Lopez RN. Exclusive enteral nutrition in children with Crohn’s diease. World J Gastroenterol 2015; 21: 6809–6816. [Link]
55.
Church PC, et al. Infliximab maintains durable response and facilitates catch-up growth in luminal pediatricCrohn's disease. Inflamm Bowel Dis 2014; 20: 1177–1186. [Link]
56.
Malik S, et al. Growth in children receiving contemporary disease specific therapy for Crohn's disease. Arch Dis Child 2012; 97: 698–703. [Link]
57.
Malik S, et al. The effects of anti-TNF-α treatment with adalimumab on growth in children with Crohn's disease (CD). J Crohns Colitis 2012; 6: 337–344. [Link]
58.
Hojsak I, et al. Long-term outcomes after elective ileocecal resection in children with active localized Crohn's disease—a multicenter European study. J Pediatr Surg 2015; 50: 1630–1635. [Link]

Abstract

People with faecal incontinence (FI) suffer from chronic involuntary loss of bowel content. Patients often experience embarrassment, shame, low self-esteem, and depression, affecting their quality of life. Treatment approaches vary, and less invasive options should be tried before considering more invasive treatments. It's important to consider contributing factors, physician and patient preferences, and available procedures. This article discusses common mistakes in treating faecal incontinence and how to avoid them, based on evidence and clinical experience.

Topics

Neurogastroenterology & Motility

Citation

Assmann S L, Breukink S O and Keszthelyi D. Mistakes in faecal incontinence management and how to avoid them. UEG Education 2023; 23: 1-3.

Published

2023

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UEG Mistakes In Articles
Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Log in to continue.

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Log In Create a free account

Not sure what you can access? Learn more about account types.

Mistakes in coeliac disease diagnosis and how to avoid them

Roberto De Giorgio 1, Giacomo Caio 1, Umberto Volta 1

Affiliations

1 University of Bologna, Italy

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Ghione S, et al. Dramatic Increase in Incidence of Ulcerative Colitis and Crohn's Disease (1988-2011): A Population-Based Study of French Adolescents. Am J Gastroenterol Epub ahead of print 15 August 2017. doi: 10.1038/ajg.2017.228. [Link]
2.
Pigneur B, et al. Natural history of Crohn’s disease: comparison between childhood- and adult-onset disease. Inflamm Bowel Dis 2010; 16: 953–961. [Link]
3.
Benchimol EI, et al. Epidemiology of pediatric inflammatory bowel disease: A systematic review of international trends. Inflamm Bowel Dis 2011; 17: 423–439. [Link]
4.
Oliveira SB and Monteiro IM. Diagnosis and management of inflammatory bowel disease in children. BMJ 2017; 357: j2083. [Link]
5.
Abramson O, et al. Incidence, prevalence, and time trends of pediatric inflammatory bowel disease in Northern California, 1996 to 2006. J Pediatr 2010; 157: 233–239.e1. [Link]
6.
Fell JM, et al. Management of ulcerative colitis. Arch Dis Child 2016; 101: 469–474. [Link]
7.
Levine A, et al. ESPGHAN revised porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents. J Pediatr Gastroenterol Nutr 2014; 58: 795–806. [Link]
8.
Uhlig HH, et al. The diagnostic approach to monogenic very early onset inflammatory bowel disease. Gastroenterology 2014; 147: 990–1007.e3. [Link]
9.
Rothenberg ME. Eosinophilic gastrointestinal disorders (EGID). J Allergy Clin Immunol 2004; 113: 11–28. [Link]
10.
Boyce JA, et al. Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored expert panel report. J Am Diet Assoc 2011; 111: 17–27. [Link]
11.
Gerasimidis K, et al. The epidemiology of anemia in pediatric inflammatory bowel disease: prevalence and associated factors at diagnosis and follow-up and the impact of exclusive enteral nutrition. Inflamm Bowel Dis 2013; 19: 2411–2422. [Link]
12.
Dignass AU, et al. European consensus on the diagnosis and management of iron deficiency and anaemia in inflammatory bowel diseases. J Crohns Colitis 2015; 9: 211–222. [Link]
13.
Thayu M and Mamula P. Treatment of iron deficiency anemia in pediatric inflammatory bowel disease. Curr Treat Options Gastro 2005; 8: 411–417. [Link]
14.
Henderson P, et al. The diagnostic accuracy of fecal calprotectin during the investigation of suspected pediatric inflammatory bowel disease: a systematic review and meta-analysis. Am J Gastroenterol 2014; 109: 637–645. [Link]
15.
Zhu Q, et al. Fecal calprotectin in healthy children aged 1–4 years. PLoS One 2016; 11: e0150725. [Link]
16.
Oord T and Hornung N. Fecal calprotectin in healthy children. Scand J Clin Lab Invest 2014; 74: 254–258. [Link]
17.
Heuschkel RB, et al. Enteral nutrition and corticosteroids in the treatment of acute Crohn's disease in children. J Pediatr Gastroenterol Nutr 2000; 31: 8–15. [Link]
18.
Swaminath A, et al. Systematic review with meta-analysis: enteral nutrition therapy for the induction of remission in paediatric Crohn's disease. Aliment Pharmacol Ther 2017; 46: 645–656. [Link]
19.
Zachos M, et al. Enteral nutritional therapy for induction of remission in Crohn’s disease. Cochrane Database Syst Rev 2007; 1: CD000542. [Link]
20.
Day AS, et al. Systematic review: nutritional therapy in paediatric Crohn's disease. Aliment Pharmacol Ther 2008; 27: 293–307. [Link]
21.
Afzal NA, et al. Colonic Crohn’s disease in children does not respond well to treatment with enteral nutrition if the ileum is not involved. Dig Dis Sci 2005; 50: 1471–1475. [Link]
22.
Buchanan E, et al. The use of exclusive enteral nutrition for induction of remission in children with Crohn’s disease demonstrates that disease phenotype does not influence clinical remission. Aliment Pharmacol Ther 2009; 30: 501–507. [Link]
23.
Ruemmele FM, et al. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease. J Crohns Colitis 2014; 8: 1179–1207. [Link]
24.
Critch J, et al. Use of enteral nutrition for the control of intestinal inflammation in pediatric Crohn disease. J Pediatr Gastroenterol Nutr 2012; 54: 298–305. [Link]
25.
Ludvigsson JF, et al. Elemental versus polymeric enteral nutrition in paediatric Crohn's disease: a multicentre randomized controlled trial. Acta Paediatr 2004; 93: 327–335. [Link]
26.
Rodrigues AF, et al. Does polymeric formula improve adherence to liquid diet therapy in children with active Crohn's disease? Arch Dis Child 2007; 92: 767–770. [Link]
27.
Yamamoto T, et al. Enteral nutrition for the maintenance of remission in Crohn's disease: a systematic review. Eur J Gastroenterol Hepatol 2010; 22: 1–8. [Link]
28.
Schulman JM, et al. Maintenance of remission with partial enteral nutrition therapy in pediatric crohn's disease: a retrospective study. Can J Gastroenterol Hepatol 2017; 2017: 5873158. [Link]
29.
Akobeng AK and Thomas AG. Enteral nutrition for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev 2007; 3: CD005984. [Link]
30.
Duncan H, et al. A retrospective study showing maintenance treatment options for paediatric CD in the first year following diagnosis after induction of remission with EEN: supplemental enteral nutrition is better than nothing! BMC Gastroenterol 2014; 14: 50. [Link]
31.
Hanai H, et al. Nutritional therapy versus 6-mercaptopurine as maintenance therapy in patients with Crohn's disease. Dig Liver Dis 2012; 44: 649–654. [Link]
32.
Takagi S, et al. Effectiveness of an 'half elemental diet' as maintenance therapy for Crohn's disease: A randomized-controlled trial. Aliment Pharmacol Ther 2006; 24: 1333–1340. [Link]
33.
Guariso G and Gasparetto M. Treating children with inflammatory bowel disease: Current and new perspectives. World J Gastroenterol 2014; 23: 5469–5485. [Link]
34.
Nuffield Orthopaedic Centre NHS Trust and Oxfordshire Primary Care Trust Shared Care Protocol and Infocation for GPs. Azathioprine (paediatric), http://www.ouh.nhs.uk/oxparc/professionals/documents/AzathiaprinePAEDIATRICRheumatologysharedcareprotocolJuly11.pdf (2011, accessed 15 January 2018). [Link]
35.
Turner D, et al. Management of pediatric ulcerative colitis: joint ECCO and ESPGHAN evidence-based consensus guidelines. J Pediatr Gastroenterol Nutr 2012; 55: 340–361. [Link]
36.
Fuentes D, et al. High-dose azathioprine in children with inflammatory bowel disease. Aliment Pharmacol Ther 2003; 17: 913–921. [Link]
37.
Feagan BG and Macdonald JK. Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis. Cochrane Database Syst Rev 2012; 10: CD000543. [Link]
38.
Turner D, et al. Once- versus twice-daily mesalazine to induce remission in paediatric ulcerative colitis: a randomised controlled trial. J Crohns Colitis 2017; 11: 527–533. [Link]
39.
Levine A, et al. Mesalamine enemas for induction of remission in oral mesalamine-refractory pediatric ulcerative colitis: a prospective cohort study. J Crohns Colitis 2017; 11: 970–974. [Link]
40.
Parashette KR, et al. Infliximab therapy in pediatric Crohn's disease: a review. Clin Exp Gastroenterol 2010; 3: 57–63. [Link]
41.
de Ridder L, et al. Use of biosimilars in paediatric inflammatory bowel disease: a position statement of the ESPGHAN Paediatric IBD Porto Group. J Pediatr Gastroenterol Nutr 2015; 61: 503–508. [Link]
42.
Hyams J, et al. Induction and maintenance infliximab therapy for the treatment of moderate-to-severe Crohn's disease in children. Gastroenterology 2007; 132: 863–873. [Link]
43.
Friesen CA, et al. Safety of infliximab treatment in pediatric patients with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2004; 39: 265–259. [Link]
44.
Dupont-Lucas C, et al. Identifying patients at high risk of loss of response to infliximab maintenance therapy in paediatric Crohn's Disease. J Crohns Colitis 2016; 10: 795–804. [Link]
45.
De Bie CI, et al. The duration of effect of infliximab maintenance treatment in paediatric Crohn's disease is limited. Aliment Pharmacol Ther 2011; 33: 243–250. [Link]
46.
Baert F, et al. Influence of immunogenicity on the long-term efficacy of infliximab in Crohn's disease. N Engl J Med 2003; 348: 601–608. [Link]
47.
Lichtenstein L, et al. Infliximab-related infusion reactions: systematic review. J Crohns Colitis 2015; 9: 806–815. [Link]
48.
Miele E, et al. Human antichimeric antibody in children and young adults with inflammatory bowel disease receiving infliximab. J Pediatr Gastroenterol Nutr 2004; 38: 502–508. [Link]
49.
Kirschner BS and Rich BH. Puberty and pediatric-onset inflammatory bowel disease. In: Mamula P, Markowitz JE and Baldassano RN (eds) Pediatric Inflammatory Bowel Diseases. New York: Springer; 2008. pp 133–139.
50.
Abraham BP, et al. Natural history of pediatric-onset inflammatory bowel disease: a systematic review. J Clin Gastroenterol 2012; 46: 581–589. [Link]
51.
Heuschkel R, et al. Guidelines for the management of growth failure in childhood inflammatory bowel disease. Inflamm Bowel Dis 2008; 14: 839–849. [Link]
52.
Sawczenko A, et al. Adult height in patients with early onset of Crohn’s disease. Gut 2003; 52: 454–455. [Link]
53.
Grover Z and Lewindon P. Two-year outcomes after exlcusive early enteral nutrition inductions are superior to corticosteroids in pediatric Crohn’s disease treated early with thiopurines. Dig Dis Sci 2015; 60: 3069–3074. [Link]
54.
Day AS and Lopez RN. Exclusive enteral nutrition in children with Crohn’s diease. World J Gastroenterol 2015; 21: 6809–6816. [Link]
55.
Church PC, et al. Infliximab maintains durable response and facilitates catch-up growth in luminal pediatricCrohn's disease. Inflamm Bowel Dis 2014; 20: 1177–1186. [Link]
56.
Malik S, et al. Growth in children receiving contemporary disease specific therapy for Crohn's disease. Arch Dis Child 2012; 97: 698–703. [Link]
57.
Malik S, et al. The effects of anti-TNF-α treatment with adalimumab on growth in children with Crohn's disease (CD). J Crohns Colitis 2012; 6: 337–344. [Link]
58.
Hojsak I, et al. Long-term outcomes after elective ileocecal resection in children with active localized Crohn's disease—a multicenter European study. J Pediatr Surg 2015; 50: 1630–1635. [Link]

Abstract

Coeliac disease is an autoimmune disorder triggered by gluten, which activates an immune reaction against the autoantigen tissue transglutaminase (TG2) in genetically predisposed subjects. Genetic susceptibility to coeliac disease has been proven by its close linkage with major histocompatibility complex (MHC) class II human leukocyte antigen (HLA) DQ2 and DQ8 haplotypes. The identification of biomarkers for coeliac disease (e.g. endomysial antibodies [EmA] and antibodies to TG2 [anti-TG2]) has changed the epidemiology of coeliac disease from being a rare to a frequent condition, with an expected prevalence of 1% in the worldwide population. Coeliac disease can be difficult to diagnose because symptoms vary from patient to patient, and the majority of patients who have coeliac disease remain undiagnosed. Small intestinal biopsy remains the gold standard for coeliac disease diagnosis, and a delayed diagnosis in the elderly can be considered a risk factor for complications. Complicated coeliac disease is not so frequent, but for those who have it, the prognosis is very poor, with a low rate of survival after 5 years.

Topics

Small Intestine & Nutrition

Published

2024

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UEG Mistakes In Articles
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Mistakes in transitional care for children and young adults and how to avoid them

Patrizia Burra, Hans Törnblom, Jorge Amil Dias, Moriam Mustapha

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Ghione S, et al. Dramatic Increase in Incidence of Ulcerative Colitis and Crohn's Disease (1988-2011): A Population-Based Study of French Adolescents. Am J Gastroenterol Epub ahead of print 15 August 2017. doi: 10.1038/ajg.2017.228. [Link]
2.
Pigneur B, et al. Natural history of Crohn’s disease: comparison between childhood- and adult-onset disease. Inflamm Bowel Dis 2010; 16: 953–961. [Link]
3.
Benchimol EI, et al. Epidemiology of pediatric inflammatory bowel disease: A systematic review of international trends. Inflamm Bowel Dis 2011; 17: 423–439. [Link]
4.
Oliveira SB and Monteiro IM. Diagnosis and management of inflammatory bowel disease in children. BMJ 2017; 357: j2083. [Link]
5.
Abramson O, et al. Incidence, prevalence, and time trends of pediatric inflammatory bowel disease in Northern California, 1996 to 2006. J Pediatr 2010; 157: 233–239.e1. [Link]
6.
Fell JM, et al. Management of ulcerative colitis. Arch Dis Child 2016; 101: 469–474. [Link]
7.
Levine A, et al. ESPGHAN revised porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents. J Pediatr Gastroenterol Nutr 2014; 58: 795–806. [Link]
8.
Uhlig HH, et al. The diagnostic approach to monogenic very early onset inflammatory bowel disease. Gastroenterology 2014; 147: 990–1007.e3. [Link]
9.
Rothenberg ME. Eosinophilic gastrointestinal disorders (EGID). J Allergy Clin Immunol 2004; 113: 11–28. [Link]
10.
Boyce JA, et al. Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored expert panel report. J Am Diet Assoc 2011; 111: 17–27. [Link]
11.
Gerasimidis K, et al. The epidemiology of anemia in pediatric inflammatory bowel disease: prevalence and associated factors at diagnosis and follow-up and the impact of exclusive enteral nutrition. Inflamm Bowel Dis 2013; 19: 2411–2422. [Link]
12.
Dignass AU, et al. European consensus on the diagnosis and management of iron deficiency and anaemia in inflammatory bowel diseases. J Crohns Colitis 2015; 9: 211–222. [Link]
13.
Thayu M and Mamula P. Treatment of iron deficiency anemia in pediatric inflammatory bowel disease. Curr Treat Options Gastro 2005; 8: 411–417. [Link]
14.
Henderson P, et al. The diagnostic accuracy of fecal calprotectin during the investigation of suspected pediatric inflammatory bowel disease: a systematic review and meta-analysis. Am J Gastroenterol 2014; 109: 637–645. [Link]
15.
Zhu Q, et al. Fecal calprotectin in healthy children aged 1–4 years. PLoS One 2016; 11: e0150725. [Link]
16.
Oord T and Hornung N. Fecal calprotectin in healthy children. Scand J Clin Lab Invest 2014; 74: 254–258. [Link]
17.
Heuschkel RB, et al. Enteral nutrition and corticosteroids in the treatment of acute Crohn's disease in children. J Pediatr Gastroenterol Nutr 2000; 31: 8–15. [Link]
18.
Swaminath A, et al. Systematic review with meta-analysis: enteral nutrition therapy for the induction of remission in paediatric Crohn's disease. Aliment Pharmacol Ther 2017; 46: 645–656. [Link]
19.
Zachos M, et al. Enteral nutritional therapy for induction of remission in Crohn’s disease. Cochrane Database Syst Rev 2007; 1: CD000542. [Link]
20.
Day AS, et al. Systematic review: nutritional therapy in paediatric Crohn's disease. Aliment Pharmacol Ther 2008; 27: 293–307. [Link]
21.
Afzal NA, et al. Colonic Crohn’s disease in children does not respond well to treatment with enteral nutrition if the ileum is not involved. Dig Dis Sci 2005; 50: 1471–1475. [Link]
22.
Buchanan E, et al. The use of exclusive enteral nutrition for induction of remission in children with Crohn’s disease demonstrates that disease phenotype does not influence clinical remission. Aliment Pharmacol Ther 2009; 30: 501–507. [Link]
23.
Ruemmele FM, et al. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease. J Crohns Colitis 2014; 8: 1179–1207. [Link]
24.
Critch J, et al. Use of enteral nutrition for the control of intestinal inflammation in pediatric Crohn disease. J Pediatr Gastroenterol Nutr 2012; 54: 298–305. [Link]
25.
Ludvigsson JF, et al. Elemental versus polymeric enteral nutrition in paediatric Crohn's disease: a multicentre randomized controlled trial. Acta Paediatr 2004; 93: 327–335. [Link]
26.
Rodrigues AF, et al. Does polymeric formula improve adherence to liquid diet therapy in children with active Crohn's disease? Arch Dis Child 2007; 92: 767–770. [Link]
27.
Yamamoto T, et al. Enteral nutrition for the maintenance of remission in Crohn's disease: a systematic review. Eur J Gastroenterol Hepatol 2010; 22: 1–8. [Link]
28.
Schulman JM, et al. Maintenance of remission with partial enteral nutrition therapy in pediatric crohn's disease: a retrospective study. Can J Gastroenterol Hepatol 2017; 2017: 5873158. [Link]
29.
Akobeng AK and Thomas AG. Enteral nutrition for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev 2007; 3: CD005984. [Link]
30.
Duncan H, et al. A retrospective study showing maintenance treatment options for paediatric CD in the first year following diagnosis after induction of remission with EEN: supplemental enteral nutrition is better than nothing! BMC Gastroenterol 2014; 14: 50. [Link]
31.
Hanai H, et al. Nutritional therapy versus 6-mercaptopurine as maintenance therapy in patients with Crohn's disease. Dig Liver Dis 2012; 44: 649–654. [Link]
32.
Takagi S, et al. Effectiveness of an 'half elemental diet' as maintenance therapy for Crohn's disease: A randomized-controlled trial. Aliment Pharmacol Ther 2006; 24: 1333–1340. [Link]
33.
Guariso G and Gasparetto M. Treating children with inflammatory bowel disease: Current and new perspectives. World J Gastroenterol 2014; 23: 5469–5485. [Link]
34.
Nuffield Orthopaedic Centre NHS Trust and Oxfordshire Primary Care Trust Shared Care Protocol and Infocation for GPs. Azathioprine (paediatric), http://www.ouh.nhs.uk/oxparc/professionals/documents/AzathiaprinePAEDIATRICRheumatologysharedcareprotocolJuly11.pdf (2011, accessed 15 January 2018). [Link]
35.
Turner D, et al. Management of pediatric ulcerative colitis: joint ECCO and ESPGHAN evidence-based consensus guidelines. J Pediatr Gastroenterol Nutr 2012; 55: 340–361. [Link]
36.
Fuentes D, et al. High-dose azathioprine in children with inflammatory bowel disease. Aliment Pharmacol Ther 2003; 17: 913–921. [Link]
37.
Feagan BG and Macdonald JK. Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis. Cochrane Database Syst Rev 2012; 10: CD000543. [Link]
38.
Turner D, et al. Once- versus twice-daily mesalazine to induce remission in paediatric ulcerative colitis: a randomised controlled trial. J Crohns Colitis 2017; 11: 527–533. [Link]
39.
Levine A, et al. Mesalamine enemas for induction of remission in oral mesalamine-refractory pediatric ulcerative colitis: a prospective cohort study. J Crohns Colitis 2017; 11: 970–974. [Link]
40.
Parashette KR, et al. Infliximab therapy in pediatric Crohn's disease: a review. Clin Exp Gastroenterol 2010; 3: 57–63. [Link]
41.
de Ridder L, et al. Use of biosimilars in paediatric inflammatory bowel disease: a position statement of the ESPGHAN Paediatric IBD Porto Group. J Pediatr Gastroenterol Nutr 2015; 61: 503–508. [Link]
42.
Hyams J, et al. Induction and maintenance infliximab therapy for the treatment of moderate-to-severe Crohn's disease in children. Gastroenterology 2007; 132: 863–873. [Link]
43.
Friesen CA, et al. Safety of infliximab treatment in pediatric patients with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2004; 39: 265–259. [Link]
44.
Dupont-Lucas C, et al. Identifying patients at high risk of loss of response to infliximab maintenance therapy in paediatric Crohn's Disease. J Crohns Colitis 2016; 10: 795–804. [Link]
45.
De Bie CI, et al. The duration of effect of infliximab maintenance treatment in paediatric Crohn's disease is limited. Aliment Pharmacol Ther 2011; 33: 243–250. [Link]
46.
Baert F, et al. Influence of immunogenicity on the long-term efficacy of infliximab in Crohn's disease. N Engl J Med 2003; 348: 601–608. [Link]
47.
Lichtenstein L, et al. Infliximab-related infusion reactions: systematic review. J Crohns Colitis 2015; 9: 806–815. [Link]
48.
Miele E, et al. Human antichimeric antibody in children and young adults with inflammatory bowel disease receiving infliximab. J Pediatr Gastroenterol Nutr 2004; 38: 502–508. [Link]
49.
Kirschner BS and Rich BH. Puberty and pediatric-onset inflammatory bowel disease. In: Mamula P, Markowitz JE and Baldassano RN (eds) Pediatric Inflammatory Bowel Diseases. New York: Springer; 2008. pp 133–139.
50.
Abraham BP, et al. Natural history of pediatric-onset inflammatory bowel disease: a systematic review. J Clin Gastroenterol 2012; 46: 581–589. [Link]
51.
Heuschkel R, et al. Guidelines for the management of growth failure in childhood inflammatory bowel disease. Inflamm Bowel Dis 2008; 14: 839–849. [Link]
52.
Sawczenko A, et al. Adult height in patients with early onset of Crohn’s disease. Gut 2003; 52: 454–455. [Link]
53.
Grover Z and Lewindon P. Two-year outcomes after exlcusive early enteral nutrition inductions are superior to corticosteroids in pediatric Crohn’s disease treated early with thiopurines. Dig Dis Sci 2015; 60: 3069–3074. [Link]
54.
Day AS and Lopez RN. Exclusive enteral nutrition in children with Crohn’s diease. World J Gastroenterol 2015; 21: 6809–6816. [Link]
55.
Church PC, et al. Infliximab maintains durable response and facilitates catch-up growth in luminal pediatricCrohn's disease. Inflamm Bowel Dis 2014; 20: 1177–1186. [Link]
56.
Malik S, et al. Growth in children receiving contemporary disease specific therapy for Crohn's disease. Arch Dis Child 2012; 97: 698–703. [Link]
57.
Malik S, et al. The effects of anti-TNF-α treatment with adalimumab on growth in children with Crohn's disease (CD). J Crohns Colitis 2012; 6: 337–344. [Link]
58.
Hojsak I, et al. Long-term outcomes after elective ileocecal resection in children with active localized Crohn's disease—a multicenter European study. J Pediatr Surg 2015; 50: 1630–1635. [Link]

Abstract

Children and adolescents with chronic diseases requiring lifelong care face unique challenges that affect their daily lives and those of their families. Initially, these patients receive specialized care in pediatric facilities, where parents play a key role in treatment decisions. However, transitioning to adult healthcare facilities is inevitable, and this process, recognized as crucial years ago, involves moving adolescents with chronic conditions from child-centered to adult-oriented care. This transition can be complicated by varying age limits for pediatric care and the scarcity of adult care centers with specific expertise. The transition often requires cooperation between different centers or even countries due to patient mobility. The transition phase is critical, as it can lead to loss of follow-up, treatment suspension, and increased risks of complications or disease relapse. Beyond medical management, various factors influence the long-term prognosis of chronic conditions, making a well-organized transition program essential. While many hospitals have implemented transition models with mixed results in satisfaction, disease control, and follow-up adherence, there are frequent shortcomings in the process. This Mistakes In article will outline eight common mistakes made during the transition from pediatric to adult care, supported by literature and professional experience.

Topics

Primary Care

Citation

Jorge Amil-Dias, Hans Törnblom, Moriam Mustapha and Patrizia Burra. Mistakes in transitional care for children and young adults and how to avoid them. UEG Education 2023; 23: 22-25.

Published

2023

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UEG Mistakes In Articles
Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Log in to continue.

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Log In Create a free account

Not sure what you can access? Learn more about account types.

Mistakes in nutrition in IBD and how to avoid them

Richard K Russell, Konstantinos Gerasimidis

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Ghione S, et al. Dramatic Increase in Incidence of Ulcerative Colitis and Crohn's Disease (1988-2011): A Population-Based Study of French Adolescents. Am J Gastroenterol Epub ahead of print 15 August 2017. doi: 10.1038/ajg.2017.228. [Link]
2.
Pigneur B, et al. Natural history of Crohn’s disease: comparison between childhood- and adult-onset disease. Inflamm Bowel Dis 2010; 16: 953–961. [Link]
3.
Benchimol EI, et al. Epidemiology of pediatric inflammatory bowel disease: A systematic review of international trends. Inflamm Bowel Dis 2011; 17: 423–439. [Link]
4.
Oliveira SB and Monteiro IM. Diagnosis and management of inflammatory bowel disease in children. BMJ 2017; 357: j2083. [Link]
5.
Abramson O, et al. Incidence, prevalence, and time trends of pediatric inflammatory bowel disease in Northern California, 1996 to 2006. J Pediatr 2010; 157: 233–239.e1. [Link]
6.
Fell JM, et al. Management of ulcerative colitis. Arch Dis Child 2016; 101: 469–474. [Link]
7.
Levine A, et al. ESPGHAN revised porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents. J Pediatr Gastroenterol Nutr 2014; 58: 795–806. [Link]
8.
Uhlig HH, et al. The diagnostic approach to monogenic very early onset inflammatory bowel disease. Gastroenterology 2014; 147: 990–1007.e3. [Link]
9.
Rothenberg ME. Eosinophilic gastrointestinal disorders (EGID). J Allergy Clin Immunol 2004; 113: 11–28. [Link]
10.
Boyce JA, et al. Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored expert panel report. J Am Diet Assoc 2011; 111: 17–27. [Link]
11.
Gerasimidis K, et al. The epidemiology of anemia in pediatric inflammatory bowel disease: prevalence and associated factors at diagnosis and follow-up and the impact of exclusive enteral nutrition. Inflamm Bowel Dis 2013; 19: 2411–2422. [Link]
12.
Dignass AU, et al. European consensus on the diagnosis and management of iron deficiency and anaemia in inflammatory bowel diseases. J Crohns Colitis 2015; 9: 211–222. [Link]
13.
Thayu M and Mamula P. Treatment of iron deficiency anemia in pediatric inflammatory bowel disease. Curr Treat Options Gastro 2005; 8: 411–417. [Link]
14.
Henderson P, et al. The diagnostic accuracy of fecal calprotectin during the investigation of suspected pediatric inflammatory bowel disease: a systematic review and meta-analysis. Am J Gastroenterol 2014; 109: 637–645. [Link]
15.
Zhu Q, et al. Fecal calprotectin in healthy children aged 1–4 years. PLoS One 2016; 11: e0150725. [Link]
16.
Oord T and Hornung N. Fecal calprotectin in healthy children. Scand J Clin Lab Invest 2014; 74: 254–258. [Link]
17.
Heuschkel RB, et al. Enteral nutrition and corticosteroids in the treatment of acute Crohn's disease in children. J Pediatr Gastroenterol Nutr 2000; 31: 8–15. [Link]
18.
Swaminath A, et al. Systematic review with meta-analysis: enteral nutrition therapy for the induction of remission in paediatric Crohn's disease. Aliment Pharmacol Ther 2017; 46: 645–656. [Link]
19.
Zachos M, et al. Enteral nutritional therapy for induction of remission in Crohn’s disease. Cochrane Database Syst Rev 2007; 1: CD000542. [Link]
20.
Day AS, et al. Systematic review: nutritional therapy in paediatric Crohn's disease. Aliment Pharmacol Ther 2008; 27: 293–307. [Link]
21.
Afzal NA, et al. Colonic Crohn’s disease in children does not respond well to treatment with enteral nutrition if the ileum is not involved. Dig Dis Sci 2005; 50: 1471–1475. [Link]
22.
Buchanan E, et al. The use of exclusive enteral nutrition for induction of remission in children with Crohn’s disease demonstrates that disease phenotype does not influence clinical remission. Aliment Pharmacol Ther 2009; 30: 501–507. [Link]
23.
Ruemmele FM, et al. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease. J Crohns Colitis 2014; 8: 1179–1207. [Link]
24.
Critch J, et al. Use of enteral nutrition for the control of intestinal inflammation in pediatric Crohn disease. J Pediatr Gastroenterol Nutr 2012; 54: 298–305. [Link]
25.
Ludvigsson JF, et al. Elemental versus polymeric enteral nutrition in paediatric Crohn's disease: a multicentre randomized controlled trial. Acta Paediatr 2004; 93: 327–335. [Link]
26.
Rodrigues AF, et al. Does polymeric formula improve adherence to liquid diet therapy in children with active Crohn's disease? Arch Dis Child 2007; 92: 767–770. [Link]
27.
Yamamoto T, et al. Enteral nutrition for the maintenance of remission in Crohn's disease: a systematic review. Eur J Gastroenterol Hepatol 2010; 22: 1–8. [Link]
28.
Schulman JM, et al. Maintenance of remission with partial enteral nutrition therapy in pediatric crohn's disease: a retrospective study. Can J Gastroenterol Hepatol 2017; 2017: 5873158. [Link]
29.
Akobeng AK and Thomas AG. Enteral nutrition for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev 2007; 3: CD005984. [Link]
30.
Duncan H, et al. A retrospective study showing maintenance treatment options for paediatric CD in the first year following diagnosis after induction of remission with EEN: supplemental enteral nutrition is better than nothing! BMC Gastroenterol 2014; 14: 50. [Link]
31.
Hanai H, et al. Nutritional therapy versus 6-mercaptopurine as maintenance therapy in patients with Crohn's disease. Dig Liver Dis 2012; 44: 649–654. [Link]
32.
Takagi S, et al. Effectiveness of an 'half elemental diet' as maintenance therapy for Crohn's disease: A randomized-controlled trial. Aliment Pharmacol Ther 2006; 24: 1333–1340. [Link]
33.
Guariso G and Gasparetto M. Treating children with inflammatory bowel disease: Current and new perspectives. World J Gastroenterol 2014; 23: 5469–5485. [Link]
34.
Nuffield Orthopaedic Centre NHS Trust and Oxfordshire Primary Care Trust Shared Care Protocol and Infocation for GPs. Azathioprine (paediatric), http://www.ouh.nhs.uk/oxparc/professionals/documents/AzathiaprinePAEDIATRICRheumatologysharedcareprotocolJuly11.pdf (2011, accessed 15 January 2018). [Link]
35.
Turner D, et al. Management of pediatric ulcerative colitis: joint ECCO and ESPGHAN evidence-based consensus guidelines. J Pediatr Gastroenterol Nutr 2012; 55: 340–361. [Link]
36.
Fuentes D, et al. High-dose azathioprine in children with inflammatory bowel disease. Aliment Pharmacol Ther 2003; 17: 913–921. [Link]
37.
Feagan BG and Macdonald JK. Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis. Cochrane Database Syst Rev 2012; 10: CD000543. [Link]
38.
Turner D, et al. Once- versus twice-daily mesalazine to induce remission in paediatric ulcerative colitis: a randomised controlled trial. J Crohns Colitis 2017; 11: 527–533. [Link]
39.
Levine A, et al. Mesalamine enemas for induction of remission in oral mesalamine-refractory pediatric ulcerative colitis: a prospective cohort study. J Crohns Colitis 2017; 11: 970–974. [Link]
40.
Parashette KR, et al. Infliximab therapy in pediatric Crohn's disease: a review. Clin Exp Gastroenterol 2010; 3: 57–63. [Link]
41.
de Ridder L, et al. Use of biosimilars in paediatric inflammatory bowel disease: a position statement of the ESPGHAN Paediatric IBD Porto Group. J Pediatr Gastroenterol Nutr 2015; 61: 503–508. [Link]
42.
Hyams J, et al. Induction and maintenance infliximab therapy for the treatment of moderate-to-severe Crohn's disease in children. Gastroenterology 2007; 132: 863–873. [Link]
43.
Friesen CA, et al. Safety of infliximab treatment in pediatric patients with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2004; 39: 265–259. [Link]
44.
Dupont-Lucas C, et al. Identifying patients at high risk of loss of response to infliximab maintenance therapy in paediatric Crohn's Disease. J Crohns Colitis 2016; 10: 795–804. [Link]
45.
De Bie CI, et al. The duration of effect of infliximab maintenance treatment in paediatric Crohn's disease is limited. Aliment Pharmacol Ther 2011; 33: 243–250. [Link]
46.
Baert F, et al. Influence of immunogenicity on the long-term efficacy of infliximab in Crohn's disease. N Engl J Med 2003; 348: 601–608. [Link]
47.
Lichtenstein L, et al. Infliximab-related infusion reactions: systematic review. J Crohns Colitis 2015; 9: 806–815. [Link]
48.
Miele E, et al. Human antichimeric antibody in children and young adults with inflammatory bowel disease receiving infliximab. J Pediatr Gastroenterol Nutr 2004; 38: 502–508. [Link]
49.
Kirschner BS and Rich BH. Puberty and pediatric-onset inflammatory bowel disease. In: Mamula P, Markowitz JE and Baldassano RN (eds) Pediatric Inflammatory Bowel Diseases. New York: Springer; 2008. pp 133–139.
50.
Abraham BP, et al. Natural history of pediatric-onset inflammatory bowel disease: a systematic review. J Clin Gastroenterol 2012; 46: 581–589. [Link]
51.
Heuschkel R, et al. Guidelines for the management of growth failure in childhood inflammatory bowel disease. Inflamm Bowel Dis 2008; 14: 839–849. [Link]
52.
Sawczenko A, et al. Adult height in patients with early onset of Crohn’s disease. Gut 2003; 52: 454–455. [Link]
53.
Grover Z and Lewindon P. Two-year outcomes after exlcusive early enteral nutrition inductions are superior to corticosteroids in pediatric Crohn’s disease treated early with thiopurines. Dig Dis Sci 2015; 60: 3069–3074. [Link]
54.
Day AS and Lopez RN. Exclusive enteral nutrition in children with Crohn’s diease. World J Gastroenterol 2015; 21: 6809–6816. [Link]
55.
Church PC, et al. Infliximab maintains durable response and facilitates catch-up growth in luminal pediatricCrohn's disease. Inflamm Bowel Dis 2014; 20: 1177–1186. [Link]
56.
Malik S, et al. Growth in children receiving contemporary disease specific therapy for Crohn's disease. Arch Dis Child 2012; 97: 698–703. [Link]
57.
Malik S, et al. The effects of anti-TNF-α treatment with adalimumab on growth in children with Crohn's disease (CD). J Crohns Colitis 2012; 6: 337–344. [Link]
58.
Hojsak I, et al. Long-term outcomes after elective ileocecal resection in children with active localized Crohn's disease—a multicenter European study. J Pediatr Surg 2015; 50: 1630–1635. [Link]

Abstract

The relationship between nutrition and inflammatory bowel disease (IBD) has been an area of substantial interest and research for many decades now. Evidence-based nutritional strategies are being utilised as a key part of the therapeutic armamentarium in Crohn’s disease for both induction and maintenance, as primary and adjuvant treatment methods. Exclusive enteral nutrition, for instance, is well established in the treatment of paediatric IBD and adult centres are increasingly incorporating it into treatment models as an effective, drug-free alternative.  The role for partial enteral nutrition and Crohn’s disease specific diets are also being more clearly elucidated. Used appropriately, and through engagement with dietetic support services, nutritional therapies can not only achieve the IBD treatment ‘targets’ but serve to optimise other vital aspects of care, such as growth, bone health, body composition and overall patient well-being. Here we discuss some of the mistakes that are frequently made in the area of nutritional management of IBD. The discussion is evidence based, with key references incorporated for further analysis beyond the scope of this article, and combines several decades of leading clinical and research experience in the area of nutrition and IBD from the authors. 


Topics

Small Intestine & Nutrition

Citation

Meredith J, Russell RK and Gerasimidis K. Mistakes in nutrition in IBD and how to avoid them. UEG Education 2020; 20: 25–30.

Published

2020

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UEG Mistakes In Articles
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Mistakes in short bowel and how to avoid them

Simon Gabe, Jeremy Nightingale, Siddhartha Oke

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Summary is not available for this content yet.

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References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Ghione S, et al. Dramatic Increase in Incidence of Ulcerative Colitis and Crohn's Disease (1988-2011): A Population-Based Study of French Adolescents. Am J Gastroenterol Epub ahead of print 15 August 2017. doi: 10.1038/ajg.2017.228. [Link]
2.
Pigneur B, et al. Natural history of Crohn’s disease: comparison between childhood- and adult-onset disease. Inflamm Bowel Dis 2010; 16: 953–961. [Link]
3.
Benchimol EI, et al. Epidemiology of pediatric inflammatory bowel disease: A systematic review of international trends. Inflamm Bowel Dis 2011; 17: 423–439. [Link]
4.
Oliveira SB and Monteiro IM. Diagnosis and management of inflammatory bowel disease in children. BMJ 2017; 357: j2083. [Link]
5.
Abramson O, et al. Incidence, prevalence, and time trends of pediatric inflammatory bowel disease in Northern California, 1996 to 2006. J Pediatr 2010; 157: 233–239.e1. [Link]
6.
Fell JM, et al. Management of ulcerative colitis. Arch Dis Child 2016; 101: 469–474. [Link]
7.
Levine A, et al. ESPGHAN revised porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents. J Pediatr Gastroenterol Nutr 2014; 58: 795–806. [Link]
8.
Uhlig HH, et al. The diagnostic approach to monogenic very early onset inflammatory bowel disease. Gastroenterology 2014; 147: 990–1007.e3. [Link]
9.
Rothenberg ME. Eosinophilic gastrointestinal disorders (EGID). J Allergy Clin Immunol 2004; 113: 11–28. [Link]
10.
Boyce JA, et al. Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored expert panel report. J Am Diet Assoc 2011; 111: 17–27. [Link]
11.
Gerasimidis K, et al. The epidemiology of anemia in pediatric inflammatory bowel disease: prevalence and associated factors at diagnosis and follow-up and the impact of exclusive enteral nutrition. Inflamm Bowel Dis 2013; 19: 2411–2422. [Link]
12.
Dignass AU, et al. European consensus on the diagnosis and management of iron deficiency and anaemia in inflammatory bowel diseases. J Crohns Colitis 2015; 9: 211–222. [Link]
13.
Thayu M and Mamula P. Treatment of iron deficiency anemia in pediatric inflammatory bowel disease. Curr Treat Options Gastro 2005; 8: 411–417. [Link]
14.
Henderson P, et al. The diagnostic accuracy of fecal calprotectin during the investigation of suspected pediatric inflammatory bowel disease: a systematic review and meta-analysis. Am J Gastroenterol 2014; 109: 637–645. [Link]
15.
Zhu Q, et al. Fecal calprotectin in healthy children aged 1–4 years. PLoS One 2016; 11: e0150725. [Link]
16.
Oord T and Hornung N. Fecal calprotectin in healthy children. Scand J Clin Lab Invest 2014; 74: 254–258. [Link]
17.
Heuschkel RB, et al. Enteral nutrition and corticosteroids in the treatment of acute Crohn's disease in children. J Pediatr Gastroenterol Nutr 2000; 31: 8–15. [Link]
18.
Swaminath A, et al. Systematic review with meta-analysis: enteral nutrition therapy for the induction of remission in paediatric Crohn's disease. Aliment Pharmacol Ther 2017; 46: 645–656. [Link]
19.
Zachos M, et al. Enteral nutritional therapy for induction of remission in Crohn’s disease. Cochrane Database Syst Rev 2007; 1: CD000542. [Link]
20.
Day AS, et al. Systematic review: nutritional therapy in paediatric Crohn's disease. Aliment Pharmacol Ther 2008; 27: 293–307. [Link]
21.
Afzal NA, et al. Colonic Crohn’s disease in children does not respond well to treatment with enteral nutrition if the ileum is not involved. Dig Dis Sci 2005; 50: 1471–1475. [Link]
22.
Buchanan E, et al. The use of exclusive enteral nutrition for induction of remission in children with Crohn’s disease demonstrates that disease phenotype does not influence clinical remission. Aliment Pharmacol Ther 2009; 30: 501–507. [Link]
23.
Ruemmele FM, et al. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease. J Crohns Colitis 2014; 8: 1179–1207. [Link]
24.
Critch J, et al. Use of enteral nutrition for the control of intestinal inflammation in pediatric Crohn disease. J Pediatr Gastroenterol Nutr 2012; 54: 298–305. [Link]
25.
Ludvigsson JF, et al. Elemental versus polymeric enteral nutrition in paediatric Crohn's disease: a multicentre randomized controlled trial. Acta Paediatr 2004; 93: 327–335. [Link]
26.
Rodrigues AF, et al. Does polymeric formula improve adherence to liquid diet therapy in children with active Crohn's disease? Arch Dis Child 2007; 92: 767–770. [Link]
27.
Yamamoto T, et al. Enteral nutrition for the maintenance of remission in Crohn's disease: a systematic review. Eur J Gastroenterol Hepatol 2010; 22: 1–8. [Link]
28.
Schulman JM, et al. Maintenance of remission with partial enteral nutrition therapy in pediatric crohn's disease: a retrospective study. Can J Gastroenterol Hepatol 2017; 2017: 5873158. [Link]
29.
Akobeng AK and Thomas AG. Enteral nutrition for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev 2007; 3: CD005984. [Link]
30.
Duncan H, et al. A retrospective study showing maintenance treatment options for paediatric CD in the first year following diagnosis after induction of remission with EEN: supplemental enteral nutrition is better than nothing! BMC Gastroenterol 2014; 14: 50. [Link]
31.
Hanai H, et al. Nutritional therapy versus 6-mercaptopurine as maintenance therapy in patients with Crohn's disease. Dig Liver Dis 2012; 44: 649–654. [Link]
32.
Takagi S, et al. Effectiveness of an 'half elemental diet' as maintenance therapy for Crohn's disease: A randomized-controlled trial. Aliment Pharmacol Ther 2006; 24: 1333–1340. [Link]
33.
Guariso G and Gasparetto M. Treating children with inflammatory bowel disease: Current and new perspectives. World J Gastroenterol 2014; 23: 5469–5485. [Link]
34.
Nuffield Orthopaedic Centre NHS Trust and Oxfordshire Primary Care Trust Shared Care Protocol and Infocation for GPs. Azathioprine (paediatric), http://www.ouh.nhs.uk/oxparc/professionals/documents/AzathiaprinePAEDIATRICRheumatologysharedcareprotocolJuly11.pdf (2011, accessed 15 January 2018). [Link]
35.
Turner D, et al. Management of pediatric ulcerative colitis: joint ECCO and ESPGHAN evidence-based consensus guidelines. J Pediatr Gastroenterol Nutr 2012; 55: 340–361. [Link]
36.
Fuentes D, et al. High-dose azathioprine in children with inflammatory bowel disease. Aliment Pharmacol Ther 2003; 17: 913–921. [Link]
37.
Feagan BG and Macdonald JK. Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis. Cochrane Database Syst Rev 2012; 10: CD000543. [Link]
38.
Turner D, et al. Once- versus twice-daily mesalazine to induce remission in paediatric ulcerative colitis: a randomised controlled trial. J Crohns Colitis 2017; 11: 527–533. [Link]
39.
Levine A, et al. Mesalamine enemas for induction of remission in oral mesalamine-refractory pediatric ulcerative colitis: a prospective cohort study. J Crohns Colitis 2017; 11: 970–974. [Link]
40.
Parashette KR, et al. Infliximab therapy in pediatric Crohn's disease: a review. Clin Exp Gastroenterol 2010; 3: 57–63. [Link]
41.
de Ridder L, et al. Use of biosimilars in paediatric inflammatory bowel disease: a position statement of the ESPGHAN Paediatric IBD Porto Group. J Pediatr Gastroenterol Nutr 2015; 61: 503–508. [Link]
42.
Hyams J, et al. Induction and maintenance infliximab therapy for the treatment of moderate-to-severe Crohn's disease in children. Gastroenterology 2007; 132: 863–873. [Link]
43.
Friesen CA, et al. Safety of infliximab treatment in pediatric patients with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2004; 39: 265–259. [Link]
44.
Dupont-Lucas C, et al. Identifying patients at high risk of loss of response to infliximab maintenance therapy in paediatric Crohn's Disease. J Crohns Colitis 2016; 10: 795–804. [Link]
45.
De Bie CI, et al. The duration of effect of infliximab maintenance treatment in paediatric Crohn's disease is limited. Aliment Pharmacol Ther 2011; 33: 243–250. [Link]
46.
Baert F, et al. Influence of immunogenicity on the long-term efficacy of infliximab in Crohn's disease. N Engl J Med 2003; 348: 601–608. [Link]
47.
Lichtenstein L, et al. Infliximab-related infusion reactions: systematic review. J Crohns Colitis 2015; 9: 806–815. [Link]
48.
Miele E, et al. Human antichimeric antibody in children and young adults with inflammatory bowel disease receiving infliximab. J Pediatr Gastroenterol Nutr 2004; 38: 502–508. [Link]
49.
Kirschner BS and Rich BH. Puberty and pediatric-onset inflammatory bowel disease. In: Mamula P, Markowitz JE and Baldassano RN (eds) Pediatric Inflammatory Bowel Diseases. New York: Springer; 2008. pp 133–139.
50.
Abraham BP, et al. Natural history of pediatric-onset inflammatory bowel disease: a systematic review. J Clin Gastroenterol 2012; 46: 581–589. [Link]
51.
Heuschkel R, et al. Guidelines for the management of growth failure in childhood inflammatory bowel disease. Inflamm Bowel Dis 2008; 14: 839–849. [Link]
52.
Sawczenko A, et al. Adult height in patients with early onset of Crohn’s disease. Gut 2003; 52: 454–455. [Link]
53.
Grover Z and Lewindon P. Two-year outcomes after exlcusive early enteral nutrition inductions are superior to corticosteroids in pediatric Crohn’s disease treated early with thiopurines. Dig Dis Sci 2015; 60: 3069–3074. [Link]
54.
Day AS and Lopez RN. Exclusive enteral nutrition in children with Crohn’s diease. World J Gastroenterol 2015; 21: 6809–6816. [Link]
55.
Church PC, et al. Infliximab maintains durable response and facilitates catch-up growth in luminal pediatricCrohn's disease. Inflamm Bowel Dis 2014; 20: 1177–1186. [Link]
56.
Malik S, et al. Growth in children receiving contemporary disease specific therapy for Crohn's disease. Arch Dis Child 2012; 97: 698–703. [Link]
57.
Malik S, et al. The effects of anti-TNF-α treatment with adalimumab on growth in children with Crohn's disease (CD). J Crohns Colitis 2012; 6: 337–344. [Link]
58.
Hojsak I, et al. Long-term outcomes after elective ileocecal resection in children with active localized Crohn's disease—a multicenter European study. J Pediatr Surg 2015; 50: 1630–1635. [Link]

Abstract

Short bowel is a condition that occurs after single or multiple intestinal resections. The incidence of short bowel in Europe is 2 per million of the population and it carries with it lifelong morbidity and mortality. The initial recognition and management of short bowel in the adult population tends to occur in the postoperative period and in the secondary care setting, where specialist input from clinicians experienced in short bowel is often lacking.

Topics

Small Intestine & Nutrition

Citation

Oke SM, Nightingale JM and Gabe SM Mistakes in short bowel and how to avoid them. UEG Education 2018; 18: 7–11.

Published

2018

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UEG Mistakes In Articles
Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Log in to continue.

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Log In Create a free account

Not sure what you can access? Learn more about account types.

Mistakes in the management of carbohydrate intolerance and how to avoid them

Johann Hammer, Heinz Florian Hammer, Mark Fox

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Ghione S, et al. Dramatic Increase in Incidence of Ulcerative Colitis and Crohn's Disease (1988-2011): A Population-Based Study of French Adolescents. Am J Gastroenterol Epub ahead of print 15 August 2017. doi: 10.1038/ajg.2017.228. [Link]
2.
Pigneur B, et al. Natural history of Crohn’s disease: comparison between childhood- and adult-onset disease. Inflamm Bowel Dis 2010; 16: 953–961. [Link]
3.
Benchimol EI, et al. Epidemiology of pediatric inflammatory bowel disease: A systematic review of international trends. Inflamm Bowel Dis 2011; 17: 423–439. [Link]
4.
Oliveira SB and Monteiro IM. Diagnosis and management of inflammatory bowel disease in children. BMJ 2017; 357: j2083. [Link]
5.
Abramson O, et al. Incidence, prevalence, and time trends of pediatric inflammatory bowel disease in Northern California, 1996 to 2006. J Pediatr 2010; 157: 233–239.e1. [Link]
6.
Fell JM, et al. Management of ulcerative colitis. Arch Dis Child 2016; 101: 469–474. [Link]
7.
Levine A, et al. ESPGHAN revised porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents. J Pediatr Gastroenterol Nutr 2014; 58: 795–806. [Link]
8.
Uhlig HH, et al. The diagnostic approach to monogenic very early onset inflammatory bowel disease. Gastroenterology 2014; 147: 990–1007.e3. [Link]
9.
Rothenberg ME. Eosinophilic gastrointestinal disorders (EGID). J Allergy Clin Immunol 2004; 113: 11–28. [Link]
10.
Boyce JA, et al. Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored expert panel report. J Am Diet Assoc 2011; 111: 17–27. [Link]
11.
Gerasimidis K, et al. The epidemiology of anemia in pediatric inflammatory bowel disease: prevalence and associated factors at diagnosis and follow-up and the impact of exclusive enteral nutrition. Inflamm Bowel Dis 2013; 19: 2411–2422. [Link]
12.
Dignass AU, et al. European consensus on the diagnosis and management of iron deficiency and anaemia in inflammatory bowel diseases. J Crohns Colitis 2015; 9: 211–222. [Link]
13.
Thayu M and Mamula P. Treatment of iron deficiency anemia in pediatric inflammatory bowel disease. Curr Treat Options Gastro 2005; 8: 411–417. [Link]
14.
Henderson P, et al. The diagnostic accuracy of fecal calprotectin during the investigation of suspected pediatric inflammatory bowel disease: a systematic review and meta-analysis. Am J Gastroenterol 2014; 109: 637–645. [Link]
15.
Zhu Q, et al. Fecal calprotectin in healthy children aged 1–4 years. PLoS One 2016; 11: e0150725. [Link]
16.
Oord T and Hornung N. Fecal calprotectin in healthy children. Scand J Clin Lab Invest 2014; 74: 254–258. [Link]
17.
Heuschkel RB, et al. Enteral nutrition and corticosteroids in the treatment of acute Crohn's disease in children. J Pediatr Gastroenterol Nutr 2000; 31: 8–15. [Link]
18.
Swaminath A, et al. Systematic review with meta-analysis: enteral nutrition therapy for the induction of remission in paediatric Crohn's disease. Aliment Pharmacol Ther 2017; 46: 645–656. [Link]
19.
Zachos M, et al. Enteral nutritional therapy for induction of remission in Crohn’s disease. Cochrane Database Syst Rev 2007; 1: CD000542. [Link]
20.
Day AS, et al. Systematic review: nutritional therapy in paediatric Crohn's disease. Aliment Pharmacol Ther 2008; 27: 293–307. [Link]
21.
Afzal NA, et al. Colonic Crohn’s disease in children does not respond well to treatment with enteral nutrition if the ileum is not involved. Dig Dis Sci 2005; 50: 1471–1475. [Link]
22.
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Abstract

Carbohydrates not absorbed in the small intestine are fermented by colonic bacteria to organic acids and gases(e.g. carbon dioxide, hydrogen and methane), part of which is absorbed in the colon, the other part remaining in the lumen. Large interindividual differences have been demonstrated for the production of such acids and gas. Carbohydrate malabsorption can be diagnosed by using the hydrogen breath test, because the gases produced after administration of a provocative dose of carbohydrate are unique products of bacterial carbohydrate fermentation.

Topics

Small Intestine & Nutrition

Citation

Hammer HF, Hammer J and Fox M. Mistakes in the management of carbohydrate intolerance and how to avoid them. UEG Education 2019; 19: 9–14

Published

2019

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