Inflammatory bowel disease (IBD) in children and adolescents represents a rapidly growing field of research within pediatric gastroenterology. Over the past several decades, the incidence of Crohn’s disease and ulcerative colitis among children has been steadily increasing worldwide.

Unlike adult-onset IBD, IBD in childhood often involves unique genetic backgrounds, early-life environmental exposures, developing microbiomes, and greater risk of complications affecting growth, puberty, and psychosocial functioning. Recent studies have revealed that children with early-onset IBD, including very early-onset disease, frequently demonstrate distinct immunogenetic profiles, variable disease phenotypes, and heightened risk of long-term health challenges. Despite improvements in our understanding, there remain key gaps in optimal diagnostic strategies, the natural history of disease subtypes, and the best approaches to management tailored for children.

Current evidence highlights the complexities of diagnosing IBD in younger patients, who may present with atypical or subtle symptoms such as growth delay or isolated extraintestinal manifestations. Advances in diagnostic algorithms—incorporating biomarkers, imaging, endoscopic findings, histology, and when appropriate, genetic testing—have led to earlier and more accurate diagnoses, but many children still experience diagnostic delays or misdiagnoses. On the treatment front, novel therapeutics including biologics, small molecules, nutritional therapies, and individualized drug monitoring are advancing standards of care. Nevertheless, significant challenges persist, such as selecting first-line and escalation therapies, minimizing treatment side effects, addressing transition to adult care, preventing disease complications, and ensuring health equity. The interplay between dietary interventions, immune response, and the gut microbiota, as well as the psychosocial consequences of chronic disease, are also areas of active investigation and ongoing debate.

This Research Topic aims to bring together cutting-edge research and expert perspectives to advance the understanding, diagnosis, and management of IBD in children. Central objectives include specific focus on the epidemiology and natural history of IBD in children, refining diagnostic pathways, exploring advances in therapeutics, optimizing long-term health outcomes, and addressing the psychosocial and societal impacts of the disease. We encourage submissions that address knowledge gaps and foster multidisciplinary dialogue, including original research, brief research reports, case reports, and comprehensive reviews.

This Research Topic welcomes contributions that explore all aspects of IBD in children and adolescents, while focusing on both established challenges and emerging frontiers. Submissions may address, but are not limited to, the following themes:

• Epidemiology and global trends in IBD in children
• Genetic architecture and immunopathogenesis, including monogenic forms and very early-onset disease
• Microbiome, metabolome, and host–microbe interactions in IBD in children
• Innovations in diagnostic strategies: biomarkers, imaging, endoscopic and histological assessment, and differential diagnosis
• Phenotyping, risk stratification, and disease progression modelling in children
• Growth impairment, nutritional management, and diet-based therapies (including EEN)
• Medical management: use and optimization of biologics, small molecules, combination, and personalized therapy
• Monitoring mucosal and transmural healing, treat-to-target approaches
• Management of extraintestinal manifestations, perianal disease, and complications
• Surgery in children with IBD: indications, timing, outcomes, and perioperative care
• Quality of life, psychosocial aspects, and transition to adult care
• Health disparities, access to care, and global perspectives
• Novel technologies for disease monitoring and telemedicine
• Case reports on unique diagnostic or management challenges in children

Are you interested in contributing a manuscript to this Research Topic?

Inflammatory Bowel Disease in Children