Updates In The Management Of Pediatric Inflammatory Bowel Disease

Canada has one of the highest rates of childhoodonset inflammatory bowel disease (IBD) in the world, with the recent Crohn’s and Colitis Canada’s 2023 Impact of Inflammatory Bowel Disease in Canada Report demonstrating that approximately 6,158 children and youth under 18 years are living with IBD, along with 600-650 new diagnoses under age 16 per year. This number is expected to rise to 8,079 by 2035. This represents approximately 10-20% of newly diagnosed patients. Concerningly, although still relatively uncommon compared with adolescent onset IBD, the incidence has increased most significantly in children under 5 years old. Recent health administrative data demonstrated the national incidence of IBD, overall, to be 29.9 per 100,000 (95%CI: 28.3, 31.5) in 2023, with increasing incidence in pediatrics (AAPC:1.27%; 95%CI:0.82, 1.67), despite stable incidence in adults (AAPC:0.26%; 95%CI: -0.42, 0.82). Figure 1 demonstrates that this increase in pediatric incidence is a worldwide phenomenon. Current IBD care in pediatrics is moving toward a precision medicine approach, with unique and standardized approaches to genetics, risk stratification and disease phenotype, nutritional and advanced therapies, and specialized multidisciplinary clinics with knowledge of the unique challenges pediatric patients and their families face with a diagnosis of IBD.