Management of children

The aims of management of children with Crohn's disease are as follows:

• to induce remission followed by prevention of relapse (1)
• to reverse the failure of growth

According to recent data, much more widespread involvement of the gastrointestinal tract has been suggested in children with Crohn’s disease.

• majority of them have both small bowel and colonic involvement
• isolated small bowel disease is seen only in 9% and isolated colonic disease in only 7% of the children (1)

The management is in three arms:

• nutrition
• medical
• surgical

Exclusive enteral nutrition and oral corticosteroids have been the preferred treatment in most children. For children with severe disease at diagnosis, azathioprine has been used recently in some centres (1).

Reference:

• (1) British Society of Paediatrics Gastroenterology Hepatology and Nutrition (BSPGHAN) 2008. Guidelines for the Management of Inflammatory Bowel Disease (IBD) in Children in the United Kingdom