The 2023 Impact of Inflammatory Bowel Disease in Canada: Special Populations—Children and Adolescents with IBD

Abstract

Rates of inflammatory bowel disease (IBD) in Canadian children and adolescents are among the highest in the world, and the incidence is rising most rapidly in children under five years of age. These young children may have either a typical form of IBD with multi-factorial aetiology, or they may have a monogenic form. Despite the growing number of children in Canada living with this important chronic disease, there are few available medical therapies approved by Health Canada due to the omission of children from most clinical trials of newly developed biologics. As a result, off-label use of medications is common, and physicians have learned to use existing therapies more effectively. In addition, most Canadian children are treated in multidisciplinary, specialty clinics by physicians with extra training or experience in IBD, as well as specialist nurses, dietitians, mental health care providers and other allied health professionals. This specialized clinic approach has facilitated cutting edge research, led by Canadian clinicians and scientists, to understand the causes of IBD, the optimal use of therapies, and the best ways to treat children from a biopsychosocial perspective. Canadians are engaged in work to understand the monogenic causes of IBD; the interaction between genes, the environment, and the microbiome; and how to address the mental health concerns and medical needs of adolescents and young adults transitioning from paediatric to adult care.

Imaging and endoscopic tools in pediatric inflammatory bowel disease: What’s new?

“…Inflammatory bowel disease (IBD) is a chronic inflammatory disorder consisting of Crohn’s disease (CD), ulcerative colitis (UC), and IBD unclassified[ 1 , 2 ]. The incidence of IBD continues to rise, including pediatric-onset disease, with most recent estimates approaching 1.5-2.0 per 10000 person years in areas with the highest rates of disease (Europe, North America)[ 3 ].…”

Variation in the Care of Children with Inflammatory Bowel Disease Within and Across Canadian Provinces: A Multi-Province Population-Based Cohort Study

“… 4 , 5 Equitable access to high quality care is vital for all children in order to minimize long-term complications while maximizing quality of life and long-term potential. 6 …”

“…4,5 Equitable access to high quality care is vital for all children in order to minimize long-term complications while maximizing quality of life and long-term potential. 6 In this multiprovince population-based study, we (1) describe variation in health services utilization and need for surgery among children with IBD between six and 60 months following diagnosis across Canadian pediatric centers and (2) evaluate the associations between the care provided at diagnosis at each center at diagnosis and the variation in these outcomes between centers.…”

Perspectives of patients, parents, and health care providers on facilitators of and barriers to the transition from pediatric to adult care in inflammatory bowel disease: a qualitative descriptive study

“… 12 Due to this projected increase in the prevalence of IBD, there is an emphasis on young adults with IBD undergoing appropriate transitioning from the pediatric to the adult healthcare system. 13 , 14 Therefore, improving the transition process is currently of great relevance to the field of IBD.…”