Adolescent IBD: recent data and practical management

Abstract

Adolescence represents a key period in the management of inflammatory bowel disease (IBD), encapsulating physical, psychological and social change. Increasing incidence of paediatric-onset IBD has led to a growing adolescent population. This review explores contemporary challenges in adolescent IBD management, including growth and development, psychosocial factors and treatment. Growth failure, once common in paediatric-onset IBD, has decreased; however, sarcopenic obesity is increasingly recognised, impacting long-term outcomes. Anxiety and depression are widely prevalent, with bidirectional relationships between disease activity and mental health contributing to increased disease burden. Poor sleep quality and fatigue further affect quality of life. The expanding therapeutic landscape offers new agents, yet licensing delays for adolescent use remain. Long-term safety concerns, including risks to fertility and cancer development, necessitate careful integration. Non-adherence is a significant barrier to effective treatment. Transitioning to adult care is a critical period requiring structured, patient-centred approaches to optimise disease control. Multidisciplinary teams caring for individuals with IBD must recognise relevant issues such as fertility and sexual health which remain unaddressed. Surgical considerations, including ‘ostomy’ procedures, require sensitive discussions incorporating patient autonomy and psychological support. Body image concerns contribute to anxiety and depression, underscoring the need for perioperative counselling. Social factors, including school absenteeism and employment concerns, highlight the importance of holistic, flexible multidisciplinary management. Healthcare engagement on social media may aid in disseminating reliable IBD information. This review emphasises the need for an integrated, developmentally appropriate, multidisciplinary approach to ensure optimal health and well-being in adolescents with IBD.

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ORCID for James Ashton: orcid.org/0000-0003-0348-8198

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