Crohn’s disease in childhood: modern approaches to treatment (a literature review)

Abstract

The aim of the work. To provide world experience and features of Crohn’s disease (CD) treatment in children by reviewing and analyzing modern scientific literary sources, given the need to develop a unified therapeutic strategy for CD in childhood. The relevance of CD treatment in children stems from its debut in childhood in a large number of patients, in connection with this, a more severe and aggressive course; the presence of various surgical complications, a high risk of malignancy, and the absence of generally accepted approaches to conservative and surgical treatment. The analysis of the results of modern scientific and clinical studies on the treatment of CD in children with the characteristics of drug groups and their individual representatives, methods of treatment for patients with surgical complications of CD in childhood, lifestyle correction, psychosocial adaptation, enteral nutrition, rehabilitation, and dispensary observation is presented. The principle of a cascade approach to the treatment of CD is illustrated by an example of the WGO recommendations. Conclusions. The treatment of CD should be individual and comprehensive, with the simultaneous correction of local manifestations of the disease, surgical complications and changes in the general condition of a patient, as well as with dieting and lifestyle correction. The expected therapeutic effect of the use in children with CD of a large number of the proposed groups of medications is debatable or clinically unproven, which necessitates the implementation of further scientific and clinical research. The information presented will help doctors determine the optimal range of individual medical, rehabilitation measures and recommendations for everyone with CD in childhood and effectively provide active follow-up for patients.