• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.14 no.1
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• pp.1-25
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• 2011

Inflammatory bowel disease (IBD) develops during childhood or adolescence in approximately 25% of patients with IBD. Recent studies on pediatric IBD have revealed that early-onset IBD has distinct phenotype differences compared to adult onset IBD. Pediatric early-onset IBD differs in many aspects including disease type, location of the lesions, disease behavior, gender preponderance and genetically attributable risks. This review examines the currently published data on the clinical, epidemiological and genetic differences between early-onset and adult-onset IBD. And finally, therapeutic considerations in the management of pediatric-onset IBD are also discussed.

• Journal of Pharmacopuncture
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• v.21 no.4
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• pp.294-295
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• 2018

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.sup2
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• pp.67-71
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• 2008

The incidence of inflammatory bowel disease (IBD), especially Crohn disease, in children is remarkably increasing in Korea. Therefore, it is necessary for pediatrician to be aware of the initial presentation of Crohn disease and ulcerative colitis. Laboratory tests, radiologic studies, and endoscopic procedures are helpful in differentiating between them. At the time of presentation, most of children with IBD have abdominal pain, diarrhea, hematochezia and/or weight loss. However, atypical presentation of these diseases may contribute to a delay in diagnosis.

• Clinical and Experimental Pediatrics
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• v.57 no.11
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• pp.465-471
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• 2014

Inflammatory bowel disease (IBD) is a chronic relapsing disorder of unknown etiology, which is believed to be multifactorial. Recently, the incidence of pediatric IBD has steeply increased in Korea since 2000. Poorly controlled disease activity can result in complications such as intestinal fistulae, abscess, and stricture, as well as growth retardation and delayed puberty in children. Because of a lack of confirmative tests, various diagnostic modalities must be used to diagnose IBD. Onset age, location, behavior, and activity are important in selecting treatments. Monogenic IBD must be excluded among infantile and refractory very-early-onset IBD. Early aggressive therapy using biologics has recently been proposed for peripubertal children to prevent growth failure and malnutrition.

• Journal of Life Science
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• v.23 no.3
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• pp.448-461
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• 2013

Inflammatory bowel disease, known as Crohn's disease and ulcerative colitis, is an unexplained disease characterized by chronic inflammation that repeats a cycle of relapse, improvement, and complications. The cause of inflammatory bowel disease is not clearly known, but it is predicted that a complex of various factors precipitate its occurrence. In particular, inflammatory mediators, such as cytokine, induce an increase in cell-mediated inflammatory responses. Focal tissue damage then occurs in the intestinal mucosa because of the weakening of the immune-modulating functions of cotton. Immune and inflammatory responses do not decrease appropriately but continue until they lead to chronic inflammation. Current research has focused on the cytokine genes, which have important roles in these inflammatory responses. Cytokine is a glycoprotein that is produced mostly in activated immune cells. It connects the activation, multiplication, and differentiation between immune cells, which causes focal tissue damage and inflammatory response. Moreover, butyrate, which originates in dietary fiber and plays an important role in the structure and function of the intestinal area, shows control functions in the intestinal immune system by decreasing the proinflammatory cytokine and increasing the anti-inflammatory cytokine. Therefore, this research investigated the molecular mechanism of the anti-inflammatory effects of butyrate to comprehend the cytokine controlling abilities of butyrate in the immune cells. Butyrate is expected to have potential in new treatment strategies for inflammatory bowel disease.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.1
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• pp.50-56
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• 2019

The incidence of pediatric inflammatory bowel disease (IBD) is increasing worldwide, especially in the developing countries. It differs from adult disease in clinical manifestations, especially with regard to genetic predisposition in monogenic IBD. Pediatric disease also have a tendency to show more aggressive inflammation and greater extent of lesion. Newer drugs such as anti-tumor necrosis factor ${\alpha}$ have been known to make a difference in treating pediatric IBD. Recent studies suggested that the patients with high risk factors might have some benefits from earlier use of biologics. To achieve treatment goals such as relieving symptoms, optimizing growth, and improving quality of life while minimizing drug toxicity, more research is needed to develop tools for risk stratification in the use of biologics for pediatric IBD.

• The Journal of Internal Korean Medicine
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• v.36 no.3
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• pp.284-296
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• 2015

Objectives: The purpose of this study was to examine the effects of Ohmae-hwan (OMH) and Mume Fructus (MF) on inflammatory bowel disease (IBD). Methods: Mice were divided into 4 groups: a normal group, control group, MF group, and OMH group. Three groups, excluding the normal group, were fed a 5% solution of dextran sulfate sodium (DSS) in water for 10 days to induce inflammatory bowel disease. From the fourth day of DSS treatment, the control group was given distilled water only, the MF group was given MF powder in distilled water, and the OMH group was given dried OMH extract powder in distilled water for 7 days. Results: For each animal, changes in body weight, colon length, and component levels in blood and colon tissues after each treatment were noted. The weight in the control group and MF group decreased slightly compared with that in the OMH group, and the colon length in the MF group and OMH group was more than that in the control group. TNF-α and WBC were decreased in both the MF group and the OMH group. RBC was increased in the OMH group, like in the normal group, compared with the control group and MF group. Hb and PLT of each group were not significantly different. Regarding changes in the colon tissues, both the MF group and OMH groups recovered similar to the normal group. Conclusions: Thus, treatment with OMH and MF seems to be effective against inflammatory bowel disease, and OMH is likely to increase body weight and induce RBC recovery better than MF.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.3
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• pp.180-193
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• 2022

Pediatric inflammatory bowel disease (PIBD) is a multisystem disorder characterized by intestinal and extraintestinal manifestations and complications. Cerebrovascular events (CVE) are rare extraintestinal complications in patients with PIBD. Statistics show that 3.3% patients with PIBD and 1.3-6.4% adult patients with inflammatory bowel disease (IBD) experience CVE during the course of the disease. Therefore, this study aimed to review the records of children with IBD who developed CVE during the course of the disease. We retrospectively reviewed 62 cases of PIBD complicated by CVE. The mean patient age at the time of thrombotic events was 12.48±4.13 years. The incidence of ulcerative colitis was significantly higher than that of Crohn's disease (43 [70.5%] vs. 13 [21.3%] patients). Most patients (87.93%) were in the active phase of IBD at the time of CVE. The mean time interval between the onset of IBD and CVE was 20.84 weeks. Overall, 11 (26.83%) patients showed neurological symptoms of CVE at disease onset. The most frequent symptom on admission was persistent and severe headaches (67.85%). The most common site of cerebral venous thrombosis was the transverse sinuses (n=23, 53.48%). The right middle cerebral artery (n=3, 33.34%) was the predominant site of cerebral arterial infarction. Overall, 41 (69.49%) patients who were mostly administered unfractionated heparin or low-molecular-weight heparin (56.09%) recovered completely. Patients with IBD are at a risk of thromboembolism. CVE may be the most common type of thromboembolism. Based on these findings, the most common risk factor for CVE is IBD flares. In patients with CVE, anticoagulant therapy with heparin, followed by warfarin, is necessary.

• Natural Product Sciences
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• v.17 no.3
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• pp.234-238
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• 2011

We investigated the effects of fucoidan and lutein against dextran sulfate sodium (DSS)-induced mice colitis. Evaluations were made of the body weight, histological index such as crypt injury and inflammation score, biochemical factor such as serum amyloid (SAA) and MPO level data. The combination of fucoidan and lutein reduced the score of crypt injury and inflammation and markedly showed more decrease of the SAA and MPO levels than 5-ASA group. In addition, each sample of fucoidan and lutein was reduced the level of IL-6 which is stimulated by a lipopolysaccharide (LPS) in HT-29 cell line in vitro. Therefore, fucoidan and lutein may be useful as a dietary substance for preventing inflammatory bowel disease in humans.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.1
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• pp.41-49
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• 2019

Recent studies on pediatric inflammatory bowel disease (IBD) have revealed that early-onset IBD has distinct phenotypic differences compared with adult-onset IBD. In particular, very early-onset IBD (VEO-IBD) differs in many aspects, including the disease type, location of the lesions, disease behavior, and genetically attributable risks. Several genetic defects that disturb intestinal epithelial barrier function or affect immune function have been noted in these patients from the young age groups. In incidence of pediatric IBD in Korea has been increasing since the early 2000s. Neonatal or infantile-onset IBD develops in less than 1% of pediatric patients. Children with "neonatal IBD" or "infantile-onset IBD" have higher rates of affected first-degree relatives, severe disease course, and a high rate of resistance to immunosuppressive treatment. The suspicion of a monogenic cause of VEO-IBD was first confirmed by the discovery of mutations in the genes encoding the interleukin 10 (IL-10) receptors that cause impaired IL-10 signaling. Patients with such mutations typically presented with perianal fistulae, shows a poor response to medical management, and require early surgical interventions in the first year of life. To date, 60 monogenic defects have been identified in children with IBD-like phenotypes. The majority of monogenic defects presents before 6 years of age, and many present before 1 year of age. Next generation sequencing could become an important diagnostic tool in children with suspected genetic defects especially in children with VEO-IBD with severe disease phenotypes. VEO-IBD is a phenotypically and genetically distinct disease entity from adult-onset or older pediatric IBD.