British Society of Gastroenterology adult guidelines on inflammatory bowel disease: what can we learn for children and young people?

It is reported that up to 10–25% of all diagnoses of inflammatory bowel disease (IBD) occur in those aged less than 18 years.1 The long-term impact of disease for those likely to live 70+ years with the condition can be significant. Prompt diagnosis and enduring effective therapy are key to long-term disease control and minimising morbidity. Standardisation of IBD management has proven to be highly effective, and the latest iteration of the British Society of Gastroenterology (BSG) guidelines is hugely welcomed.2 This behemoth of a document, running to over 100 print pages and 781 references, provides a high-quality and comprehensive framework for best-practice decision-making. The document is highly relevant for children and young people without setting out to address paediatric-specific issues. There is no doubt that paediatric patients will benefit from the highly evidenced statements in this publication, although, as paediatricians, we also advocate for specific considerations for those aged <18 years at diagnosis. A potential benefit of these paediatric considerations will be to provide future benefit to adult populations with IBD. While international ECCO/ESPGHAN guidelines for paediatric IBD exist,3 the BSG document presents a leading, and contemporary, resource for disease management. Considering how the evidence can benefit children and young people is important. Concurrently, considering which aspects of paediatric IBD understanding and care may be relevant to adult practice is important, and we would like to highlight areas which may fulfil these criteria. The primary increases in IBD incidence are now within paediatric populations as adult-onset incidence has plateaued within developed countries.1 Many industrialised nations have now begun to reach the epidemiological stage of prevalence equilibrium.4 Within our own …