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Notes:

Volume 7, Issue 6 (Suppl)

J Gastrointest Dig Syst, an open access journal

ISSN: 2161-069X

Page 41

December 07-08, 2017 Madrid, Spain

&

13

th

International Conference on Clinical Gastroenterology & Hepatology

2

nd

International Conference on Digestive Diseases

CO-ORGANIZED EVENT

Crohn’s and ulcerative colitis

Carmen Cuffari

The John Hopkins Hospital, USA

C

rohn's disease (CD) and ulcerative colitis (UC) are common and heterogeneous chronic inflammatory bowel disorders of

childhood that account for up to 25% of all patients with inflammatory bowel disease (IBD). In CD, the familial pattern

of disease concordance would suggest that genetics contribute to disease etiology. Children are more likely to have proximal

small bowel disease complicated by stricture formation, fistulization and the need for surgical intervention. The predisposition

for small bowel disease has been associated with mutations of the nucleotide oligomerization domain 2 (NOD2)/Caspase

activation and recruitment domain 15 (CARD15) gene on chromosome 16 in 1/3 of patients with CD. Homozygous patients

also show an early age at disease onset and a relatively high relative risk for isolated stricturing distal ileal disease. Although

a vast number of other gene polymorphisms have been identified, the role for genetic testing in either the diagnosis or the

therapeutic management of patients with CD has yet to be determined. Although, the precise age of onset of CD can be difficult

to determine in children, subclinical phases of disease associate well with a decrease in weight and height velocity, and a delay

in pubertal development. A confident distinction between CD and UC also remains a taxonomic dilemma in 25% of pediatric

patients with IBD, despite recent technological advances in diagnostic techniques, including magnetic resonance enterography

(MRE), serological testing, and more recently contrast enhanced ultrasound. The early introduction of biological therapies,

either alone or concurrently with azathioprine or methotrexate have proven efficacy in maintaining long-term remission

without corticosteroids. The monitoring of drug levels, as well as neutralizing antibodies against anti-TNF therapy has allowed

physician's to individualize drug therapy to improve clinical response, and reduce the risk of drug induced toxicity. Novel

biological and immunosuppressant treatment strategies are now in development in pediatric patients with IBD with the aim at

improving overall treatment efficacy and avoid the need for surgery.

Biography

Carmen Cuffari is Associate Professor of Pediatrics at The Johns Hopkins University, USA and completed his MD from University of Ottawa. He was a Research

Assistant for Dr. S Qadir at University of Ottawa.

ccuffari@jhmi.edu

Carmen Cuffari, J Gastrointest Dig Syst 2017, 7:6(Suppl)

DOI: 10.4172/2161-069X-C1-058