IBD Resources for Professionals
About IBD
Inflammatory bowel disease (IBD) describes either of two related, but clinically and histologically distinct, diseases.
Crohn’s disease is a chronic inflammatory disorder characterized by inflammation that extends through all layers of the intestinal wall (called transmural inflammation). It can involve any part of the gastrointestinal (GI) tract from mouth to anus. The inflammation can be patchy (classically referred to as “skip lesions”) with transmural inflammation, and can lead to strictures, fistulae, and perianal involvement such as perianal fistulae or skin tags. Under the microscope, biopsies of tissue may show chronic inflammatory changes including inflammation, ulceration, architectural distortion, and clusters of immune cells (called non-caseating granulomas) that form in response to inflammation.
Ulcerative colitis is a chronic inflammatory bowel disorder characterized by inflammation involving the colon and rectum in a continuous fashion. While strictures can develop with ulcerative colitis, fistulae and perianal involvement are not seen. Histologic findings in ulcerative colitis show chronic inflammatory changes of the mucous membrane (mucosa) and submucosa that line the GI tract. Architectural distortion, mucosal infiltration of inflammatory cells, and crypt abscesses may also be present.
The prevalence of IBD in the United States has been estimated at nearly 1 in 100 Americans, and the incidence appears to be increasing, particularly in North America and Western Europe. The underlying cause of the disease is unknown, but it is hypothesized to be multi-factorial involving genetics, immune dysregulation, and environmental triggers resulting in a spontaneously relapsing and remitting disease process.
IBD treatment
Therapeutics for the treatment of IBD are expanding rapidly. Pharmaceutical therapies for IBD may include aminosalicylates (also known as 5-ASAs), immunomodulators, corticosteroids, antibiotics, biologics and small molecules. Despite this exciting time of new drug development, only a few therapies are currently approved by the U.S. Food and Drug Administration (FDA) for use in pediatrics. In some situations, off-label use of a particular therapy is necessary.
Nutritional therapy is a treatment option – either as a primary therapy alone or with medication. Collaboration with a pediatric registered dietitian and family involvement is paramount for nutritional therapy to be successful.
When patients with IBD develop complications, or are not responding to medications, surgical treatment is considered to relieve symptoms and improve the patient’s health and growth. If you would like a consultation about proceeding with surgical intervention for a patient with IBD, gastroenterologists and pediatric surgeons from Children’s Hospital of Philadelphia (CHOP) are available to help.
VEO-IBD treatment
Children who present with signs or symptoms of IBD before the age of 6 make up a unique cohort of patients who need specialized evaluation and may need different treatment than older children with IBD. Children with VEO-IBD may have an underlying immune deficiency or immune dysregulation that must be identified to choose the appropriate treatment and avoid complications of the disease. At CHOP, we have built the first and largest multidisciplinary VEO-IBD Program to meet the needs of these patients with integrated immunology, gastroenterology, and nutrition experts who personalize the care for each patient.
IBD & IBS: Symptoms, workup and when to refer to a GI specialist
In this article, GI specialists at CHOP, in collaboration with a CHOP pediatrician, offer advice on:
- What to look for when assessing patients with diarrhea and abdominal pain,
- Differentiating IBD from irritable bowel syndrome (IBS),
- What lab tests to order when the symptoms warrant,
- When to make a referral to a specialist.
Research
IBD research
The Division of Gastroenterology, Hepatology and Nutrition at CHOP has an active research program that studies the entire IBD disease continuum. The Center for Pediatric IBD has conducted many research projects to better understand IBD, advance current treatments, improve quality of life, develop new therapies, and ultimately to find a cure for IBD.
VEO-IBD research
Children with VEO-IBD may have different genetic backgrounds than other patients with IBD, and therefore, we aim to identify rare and novel genes causative for the disease. Through advances in sequencing technology – including whole genome sequencing and transcriptomics – we are studying the genetic pathways responsible for VEO-IBD. Learn about our CHOP VEO-IBD Genetic Panel.
Our breakthroughs in genetic causes of VEO-IBD have led to the detection of therapeutic targets specific for individuals’ diseases and achieving improved outcomes in their clinical care. In addition, we continue to investigate the microbial and environmental triggers for VEO-IBD and why this disease is rising in young children faster than any other age cohort with IBD.
Fellowship
The Advanced IBD Fellowship is a one- to two-year specialized training program in IBD and VEO-IBD offering unparalleled clinical depth and rigor, as well as opportunities for cutting-edge translational and basic science research. Our fellowship program is recognized by the Crohn's & Colitis Foundation. Learn more.
Professional eNewsletter
Stay in touch with the Division of Gastroenterology, Hepatology and Nutrition at CHOP. Subscribe to our professional eNewsletter to receive updates on research and educational opportunities, resources for your patients, news about our clinical programs, and more.
Videos and podcasts
Pediatric Inflammatory Bowel Disease Therapy
At the end of this session, learners will be able to explore case studies and research that support various types of therapies and medication for pediatric inflammatory bowel disease.
Pediatric Inflammatory Bowel Disease Etiology and Diagnostics
At the end of this session, learners will be able to review the current incidence of pediatric IBD, explore the complex etiology of IBD, and differentiate VEO-IBD. Learners will also discuss clinical presentation of pediatric Crohn’s disease, ulcerative colitis, and inflammatory bowel disease unspecified (IBD-U).
8th Annual IBD and VEO-IBD Virtual Symposium
This one-day virtual course provides a comprehensive overview of the genomic, immunologic and microbiome discoveries in VEO-IBD and pediatric IBD, the latest developments in research and clinical care for patients with pediatric IBD or VEO-IBD, and an in-depth look at today’s cutting-edge diagnostic tools and therapeutics.
Bowel Sounds: The Pediatric GI Podcast
In this episode of Bowel Sounds, hosts Drs. Temara Hajjat and Peter Lu talk to Judith R. Kelsen, MD, Program Director of CHOP’s Very Early Onset Inflammatory Bowel Disease Program, about the presentation, evaluation and management of children with VEO-IBD.
IBD Screening in Primary Care
In this podcast, CHOP pediatric gastroenterologist Betsy Maxwell, MD, MS, talks about the theories as to why IBD is on the rise in children, including an overlap between genetic factors, the immune system, the microbiome, and environmental triggers.
Nutrition, Microbiome and the Bowel: A Podcast
CHOP pediatric gastroenterologist Lindsey G. Albenberg, DO, offers high-quality dietary information, a look at how COVID-19 has affected people with bowel disorders, and other helpful take-home pointers.