{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:16:35Z","timestamp":1790100995487,"version":"4.0.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,5,9]],"date-time":"2020-05-09T00:00:00Z","timestamp":1588982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100011684","name":"Crohn's and Colitis Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011684","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The incidence of very early onset inflammatory bowel disease (VEOIBD) is increasing, yet the phenotype and natural history of VEOIBD are not well described.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a retrospective cohort study of patients diagnosed with VEOIBD (6 years of age and younger) between 2008 and 2013 at 25 North American centers. Eligible patients at each center were randomly selected for chart review. We abstracted data at diagnosis and at 1, 3, and 5 years after diagnosis. We compared the clinical features and outcomes with VEOIBD diagnosed younger than 3 years of age with children diagnosed with VEOIBD at age 3 to 6 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The study population included 269 children (105 [39%] Crohn\u2019s disease, 106 [39%] ulcerative colitis, and 58 [22%] IBD unclassified). The median age of diagnosis was 4.2 years (interquartile range 2.9\u20135.2). Most (94%) Crohn\u2019s disease patients had inflammatory disease behavior (B1). Isolated colitis (L2) was the most common disease location (70% of children diagnosed younger than 3 years vs 43% of children diagnosed 3 years and older; P = 0.10). By the end of follow-up, stricturing\/penetrating occurred in 7 (6.6%) children. The risk of any bowel surgery in Crohn\u2019s disease was 3% by 1 year, 12% by 3 years, and 15% by 5 years and did not differ by age at diagnosis. Most ulcerative colitis patients had pancolitis (57% of children diagnosed younger than 3 years vs 45% of children diagnosed 3 years and older; P = 0.18). The risk of colectomy in ulcerative colitis\/IBD unclassified was 0% by 1 year, 3% by 3 years, and 14% by 5 years and did not differ by age of diagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Very early onset inflammatory bowel disease has a distinct phenotype with predominantly colonic involvement and infrequent stricturing\/penetrating disease. The cumulative risk of bowel surgery in children with VEOIBD was approximately 14%\u201315% by 5 years. These data can be used to provide anticipatory guidance in this emerging patient population.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ibd\/izaa080","type":"journal-article","created":{"date-parts":[[2020,5,9]],"date-time":"2020-05-09T09:57:53Z","timestamp":1589018273000},"page":"295-302","source":"Crossref","is-referenced-by-count":41,"title":["<i>Natural History of\u2009<\/i> Very Early Onset Inflammatory Bowel Disease <i>in North America: A Retrospective Cohort Study<\/i>"],"prefix":"10.1093","volume":"27","author":[{"given":"Basavaraj","family":"Kerur","sequence":"first","affiliation":[{"name":"University of Massachusetts Medical School (UMMS) , Worcester, MA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric I","family":"Benchimol","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Eastern Ontario , Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karoline","family":"Fiedler","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa","family":"Stahl","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Colorado , Denver, CO, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Hyams","sequence":"additional","affiliation":[{"name":"Connecticut Children\u2019s Medical Center , Hartford, CT, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Stephens","sequence":"additional","affiliation":[{"name":"Center for Individualized Medicine, Mayo Clinic , Rochester, MN, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Lu","sequence":"additional","affiliation":[{"name":"Cohen Children\u2019s Medical Center of New York , New York, NY, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian","family":"Pfefferkorn","sequence":"additional","affiliation":[{"name":"Riley Children\u2019s Hospital , Indianapolis, IN, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raza","family":"Alkhouri","sequence":"additional","affiliation":[{"name":"University at Buffalo , Buffalo, NY, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Strople","sequence":"additional","affiliation":[{"name":"Ann & Robert H. Lurie Children\u2019s Hospital of Chicago , Chicago, IL, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Kelsen","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah","family":"Siebold","sequence":"additional","affiliation":[{"name":"UPMC Children\u2019s Hospital of Pittsburgh , Pittsburgh, PA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9605-3734","authenticated-orcid":false,"given":"Alka","family":"Goyal","sequence":"additional","affiliation":[{"name":"Children\u2019s Mercy , Kansas City, MO, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0042-3233","authenticated-orcid":false,"given":"Joel R","family":"Rosh","sequence":"additional","affiliation":[{"name":"Goryeb Children\u2019s Hospital\/Atlantic Health System , Morristown, NJ, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal","family":"LeLeiko","sequence":"additional","affiliation":[{"name":"Hasbro Children\u2019s Hospital , Providence, RI, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Van Limbergen","sequence":"additional","affiliation":[{"name":"Amsterdam University Medical Centres, Emma Children\u2019s Hospital , Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony L","family":"Guerrerio","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine Baltimore , MD, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Maltz","sequence":"additional","affiliation":[{"name":"Nationwide Children\u2019s Medical Center , Columbus, OH, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Karam","sequence":"additional","affiliation":[{"name":"Texas Children\u2019s Hospital , Houston, TX, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen","family":"Crowley","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital, London Health Science Centre, University of Western Ontario , London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Griffiths","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melvin B","family":"Heyman","sequence":"additional","affiliation":[{"name":"UCSF Benioff Children\u2019s Hospital , San Francisco, CA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Deneau","sequence":"additional","affiliation":[{"name":"University of Utah\/Intermountain Primary Children\u2019s Hospital , Salt Lake City, UT, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Benkov","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai , New York, NY, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Noe","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin , Milwaukee, WI, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dedrick","family":"Mouton","sequence":"additional","affiliation":[{"name":"Monroe Carell Jr. Children\u2019s Hospital at Vanderbilt , Nashville, TN, United 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