Young people, artificial nutrition and transitional care Nutrition, growth and puberty in children and adolescents with Crohnʹs disease

Of the individuals who present with Crohnʹs disease 25% are < 18 years of age, mostly ado¬lescent. Nutritional impairment and delayed growth are common at diagnosis and remain an issue during the disease course. Treatment has the primary aim to control symptoms, induce disease remission and achieve normal growth in the long term and includes nutritional support and early use of immunomodulation. Puberty may be discordant and is generally late and final adult height may not be achieved until the late teenage years. Chronic ill health and delayed growth may be accompanied by emotional and intellectual immaturity. These factors, including the varying rates of physical and emotional development, need to be considered during ado¬lescence with multidisciplinary input to ensure that the young patient is appropriately sup¬ported. Transition to adult care requires close collaboration between paediatric and healthcare teams with careful attention to nutritional, emotional and educational issues, all of which are relevant in the progression from childhood, through adolescence and to adult life.