Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Aug;4(3):97-103.
doi: 10.1159/000501519. Epub 2019 Jul 19.

An Overview of Inflammatory Bowel Disease Unclassified in Children

Affiliations
Review

An Overview of Inflammatory Bowel Disease Unclassified in Children

Lauren E Thurgate et al. Inflamm Intest Dis. 2019 Aug.

Abstract

Background: The inflammatory bowel diseases cover a diverse range of conditions generally grouped into Crohn's disease (CD) or ulcerative colitis (UC) based on clinical, laboratory, radiological, endoscopic, and histological criteria. However, inflammatory bowel disease unclassified (IBDU) is used when there are clinical and endoscopic signs of chronic colitis without specific features of UC or CD but features of both. Conjecture exists regarding IBDU, especially in children, as to whether it represents a unique childhood phenotype or whether it reflects the difficulties in assigning an IBD subtype at an early age.

Summary: This review examines the current understanding of pediatric IBDU and assesses the evidence supporting IBDU as a distinctive disease entity on the spectrum of inflammatory bowel disease.

Key messages: Pediatric-onset IBDU is more common than adult-onset IBDU. Therefore, an understanding of IBDU in this age group assumes more importance. However, there remains a paucity of information and a lack of exclusive longitudinal studies on pediatric IBDU. Subsequently there is significant disparity in the reported prevalence, clinical course, reclassification trends, and treatment responses around pediatric IBDU. Therefore, it remains challenging to chart the natural history of pediatric IBDU and consequently form an accurate understanding of where pediatric IBDU sits on the spectrum of disease.

Keywords: Crohn's disease; Disease classification; Inflammatory bowel disease; Inflammatory bowel disease unclassified; Ulcerative colitis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interests.

References

    1. Aloi M, Birimberg-Schwartz L, Buderus S, Hojsak I, Fell JM, Bronsky J, et al. Treatment Options and Outcomes of Pediatric IBDU Compared with Other IBD Subtypes: A Retrospective Multicenter Study from the IBD Porto Group of ESPGHAN. Inflamm Bowel Dis. 2016 Jun;22((6)):1378–83. - PubMed
    1. Birimberg-Schwartz L, Wilson DC, Kolho KL, Karolewska-Bochenek K, Afzal NA, Spray C, et al. paediatric IBD Porto group of ESPGHAN pANCA and ASCA in Children with IBD-Unclassified, Crohn's Colitis, and Ulcerative Colitis-A Longitudinal Report from the IBD Porto Group of ESPGHAN. Inflamm Bowel Dis. 2016 Aug;22((8)):1908–14. - PubMed
    1. Dimakou K, Pachoula I, Panayotou I, Stefanaki K, Orfanou I, Lagona E, et al. Pediatric inflammatory bowel disease in Greece: 30-years experience of a single center. Ann Gastroenterol. 2015 Jan-Mar;28((1)):81–6. - PMC - PubMed
    1. Rinawi F, Assa A, Eliakim R, Mozer-Glassberg Y, Nachmias Friedler V, Niv Y, et al. The natural history of pediatric-onset IBD-unclassified and prediction of Crohn's disease reclassification: a 27-year study. Scand J Gastroenterol. 2017 May;52((5)):558–63. - PubMed
    1. Carvalho RS, Abadom V, Dilworth HP, Thompson R, Oliva-Hemker M, Cuffari C. Indeterminate colitis: a significant subgroup of pediatric IBD. Inflamm Bowel Dis. 2006 Apr;12((4)):258–62. - PubMed