Up to 25% of patients with Crohn's disease and ulcerative colitis present before the age of 18 years. Although the pathophysiology of inflammatory bowel disease presenting in childhood does not differ fundamentally from that presenting in adulthood, managing these younger patients requires special consideration in light of growth and the potential long term consequences of both the disease and its treatments. Therapeutic approaches have changed in recent years, and there is a fuller appreciation of the role (and risks) of anti-tumour necrosis factor monoclonal therapy.
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Competing interests None.
Provenance and peer review Commissioned; externally peer reviewed.