Natural history of pediatric ulcerative colitis

Abstract

Short of a cure, the ideal therapy for ulcerative colitis quickly induces and then effectively maintains remission with healing of the colonic mucosa and presents minimal toxicity to the patient. No current therapy meets all these requirements. The natural history of ulcerative colitis will continue to change as newer therapies are introduced. At present, aminosalicylates should be used to maintain remission given their favorable side-effect profile. Immunomodulators also appear to be effective in those patients failing aminosalicylates, as is infliximab. Long term safety data will be required to better understand the risk-benefit ratio of these therapies. In the future clinicians may be able to obtain a genetic profile of their patients that will help predict response to various therapies and thereby decrease the likelihood of treatment failure and complications of ineffective treatments. As was recently noted in a review article on severe colitis in children, "only scientifically proven data developed in children will allow us to safely and convincingly move from experience derived from adult studies to the pediatric population" [46]. © 2008 Springer Science+Business Media, LLC. All rights reserved.