title: IBD across the age spectrum: is it the same disease?
abstract: IBD is a chronic disorder with disease onset ranging from early childhood to beyond the sixth decade of life. The factors that determine the age of onset currently remain unexplained. Is timing of occurrence a random event or is it indicative of different pathophysiological pathways leading to different phenotypes across the age spectrum? Over the past decade, several studies have suggested that the characteristics and natural history of IBD seem to be different according to age of onset. This heterogeneity suggests that the respective contributions of genetics, host immune system and environment to the aetiology and phenotype of Crohn's disease and ulcerative colitis are different across ages. Critical reviews that focus on differences characterizing IBD between age groups are scarce. Therefore, this Review updates the knowledge of the differences in epidemiology, clinical characteristics, and natural history of paediatric, adult and elderly-onset IBD. In addition, potential differences in host-gene-microbial interactions according to age are highlighted.
authors.affiliation: Department of Medicine, Dr Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1069, New York, NY 10029, USA.
authors.forename: Joannie
authors.initials: J
authors.lastname: Ruel
authors.affiliation: Department of Medicine, Dr Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1069, New York, NY 10029, USA.
authors.forename: Darren
authors.initials: D
authors.lastname: Ruane
authors.affiliation: Department of Medicine, Dr Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1069, New York, NY 10029, USA.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Mehandru
authors.affiliation: Gastroenterology Unit, Lille University Nord de France, CHU Lille, 2 Avenue Oscar Lambret, Lille 59 000, France.
authors.forename: Corinne
authors.initials: C
authors.lastname: Gower-Rousseau
authors.affiliation: Department of Medicine, Dr Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1069, New York, NY 10029, USA.
authors.forename: Jean-Frédéric
authors.initials: JF
authors.lastname: Colombel
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000375:Aging / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D003424:Crohn Disease / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D008875:Middle Aged; D010641:Phenotype; D015995:Prevalence; D055815:Young Adult