tailieunhanh - Ebook Clinical gastroenterology: Part 2
(BQ) Part 2 book “Clinical gastroenterology” has contents: The new economic reality in the world of IBD, managing the patient with a fecal diversion, new findings in the diagnosis and prevention of colorectal cancer in IBD, inflammatory bowel disease pathology slideshow, and other contents. | Chapter 10 State-of-the-Art Management of the Pediatric IBD Patient Marla Dubinsky Keywords Crohn’s disease • Ulcerative colitis • Inflammatory bowel disease • Epidemiology • Etiopathogenesis • Children • Corticosteroids • Growth failure • Bone mass • Dual energy X-ray adsorptiometry • Quality of life • Transition of care • Quantitative computed tomography Key Points • Approximately 20% of inflammatory bowel disease (IBD) cases present in the pediatric or adolescent age group. • Genetics and specific serum immune markers may identify children with more aggressive Crohn’s disease. • Both upper and lower endoscopies with biopsies should be performed in pediatric patients suspected of having IBD. • Earlier appropriate use of thiopurines, and subsequently biologics, should be considered in patients sick enough to require corticosteroids. • Growth failure and defective bone mass accrual are risks specific for this population that are multifactorial in nature and must be correctly identified, quantitated, and treated, when possible. • Adherence to prescribed medication regimens is low in the pediatric and adolescent population, especially among children with dysfunctional families or with poor coping strategies. M. Dubinsky (*) Pediatric IBD Center, Cedars-Sinai Medical Center, David Geffen School of Medicine, UCLA, 8700 Beverly Boulevard, Suite 1165W, Los Angeles, CA 90048, USA e-mail: dubinskym@ . Cohen (ed.), Inflammatory Bowel Disease, Clinical Gastroenterology, DOI , © Springer Science+Business Media, LLC 2011 151 152 M. Dubinsky Introduction Inflammatory bowel disease (IBD) first presents in childhood and adolescence in approximately 20% of all cases. The pediatric age group has emerged as the fastest growing incident population for IBD. Recent advances in diagnostics technologies and therapeutics have improved the care provided to these children. There are specific distinguishing features that differentiate early
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