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The Natural History of Crohn Disease in Children

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Pediatric Inflammatory Bowel Disease

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Abstract

There are many factors that determine the natural history of Crohn disease. Considerations include disease activity over time, evolution from an inflammatory phenotype to fibrostenotic or penetrating disease, development of corticosteroid dependence, need for surgery, and disease recurrence following bowel resection. Factors that are unique in the pediatric patient include disturbances of growth and development and differences in childhood quality of life measures. The impact of genotypic variants on phenotypic expression over time is only beginning to be elucidated. Without long-term data on untreated patients or placebo-controlled studies in children to draw upon, the true natural history of pediatric Crohn disease is left to be approximated by the disease course in individuals treated only with corticosteroid and/or mesalamine. With an evolving armamentarium of medical therapies available, altering the natural history to prevent complications related to both the disease and chronic corticosteroid exposure has become one of the primary targets of therapy today.

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Abbreviations

Anti-TNF:

Antitumor necrosis factor-alpha

CD:

Crohn disease

ECCDS:

European Cooperative Crohn Disease Study

HRQOL:

Health-related quality of life

IBD:

Inflammatory bowel disease

NCCDS:

National Cooperative Crohn Disease Study

SIR:

Standardized Incidence Ratio

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Authors and Affiliations

  1. Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA

    Benjamin Sahn & James Markowitz

  2. Division of Pediatric Gastroenterology, Liver Disease and Nutrition, Steven and Alexandra Cohen Children’s Medical Center of NY, New Hyde Park, NY, USA

    Benjamin Sahn & James Markowitz

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  1. Benjamin Sahn
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  2. James Markowitz
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Correspondence to Benjamin Sahn .

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Editors and Affiliations

  1. Division of GI, Hepatology & Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Petar Mamula

  2. Division of GI, Hepatology & Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Judith R. Kelsen

  3. Division of GI, Hepatology & Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Andrew B. Grossman

  4. Division of GI, Hepatology & Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Robert N. Baldassano

  5. Division of Pediatric Gastroenterology, Prisma Health Children’s Hospital—Upstate, Greenville, SC, USA

    Jonathan E. Markowitz

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Sahn, B., Markowitz, J. (2023). The Natural History of Crohn Disease in Children. In: Mamula, P., Kelsen, J.R., Grossman, A.B., Baldassano, R.N., Markowitz, J.E. (eds) Pediatric Inflammatory Bowel Disease. Springer, Cham. https://doi.org/10.1007/978-3-031-14744-9_7

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