[Inflammatory bowel disease in childhood].

Inflammatory bowel disease in childhood is becoming increasingly important as a result of a marked increase in incidence occurring over the past 20 years. In Crohn's disease the onset is commonly insidious, with symptoms such as growth failure, which do not immediately suggest intestinal disease. This may result in a correct diagnosis being delayed for several years. The role of paediatric colonoscopy is discussed, together with the macroscopic and microscopic appearances of the lesions. The indications and efficacy of drug therapy in Crohn's disease and ulcerative colitis are outlined and the importance of nutritional support, particularly in children with growth failure, is discussed. The indications for surgery are summarised and the need for a multidisciplinary approach, particularly in cases of fulminating colitis where early surgery is indicated, is emphasised. Most children with inflammatory bowel disease do reasonably well and even those children undergoing proctocolectomy adapt to a stoma provided they receive optimal psycho-social preparation and support.