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Natural History of Ulcerative Colitis in Children

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Pediatric Inflammatory Bowel Disease

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Abstract

Despite continued advances in treatment strategies, the management of ulcerative colitis in children continues to be challenging. We have learned that initial response to therapy, whether mesalamine or corticosteroids, is highly prognostic of future course. Overall, only about 40% of all newly diagnosed children are able to be successfully managed long term on mesalamine with the remainder requiring immunomodulators or more commonly today biologics. While anti-TNF therapy remains the mainstay for severe disease, other options now include anti-adhesion molecule therapy, anti-IL12/23 agents, and emerging small molecules. Nonetheless, approximately 5–10% of newly diagnosed children are or become medically refractory and require colectomy in the first 3 years after diagnosis. This challenging group will require breakthroughs in understanding disease pathogenesis and novel approaches.

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Authors and Affiliations

  1. Lehigh Valley Health, Allentown, PA, USA

    Joelynn Dailey

  2. Division of Digestive Diseases and Nutrition, Connecticut Children’s Medical Center, University of Connecticut School of Medicine, Hartford, CT, USA

    Jeffrey S. Hyams

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  1. Joelynn Dailey
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  2. Jeffrey S. Hyams
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Correspondence to Jeffrey S. Hyams .

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Editors and Affiliations

  1. Division of GI, Hepatology & Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Petar Mamula

  2. Division of GI, Hepatology & Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Judith R. Kelsen

  3. Division of GI, Hepatology & Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Andrew B. Grossman

  4. Division of GI, Hepatology & Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Robert N. Baldassano

  5. Division of Pediatric Gastroenterology, Prisma Health Children’s Hospital—Upstate, Greenville, SC, USA

    Jonathan E. Markowitz

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Dailey, J., Hyams, J.S. (2023). Natural History of Ulcerative Colitis in Children. In: Mamula, P., Kelsen, J.R., Grossman, A.B., Baldassano, R.N., Markowitz, J.E. (eds) Pediatric Inflammatory Bowel Disease. Springer, Cham. https://doi.org/10.1007/978-3-031-14744-9_8

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