Up-to-date treatment of inflammatory bowel disease in childhood Focus on diet and biological therapy

Inflammatory bowel disease (IBD) is a chronic inflammation of the intestinal tract. The pathomechanism is assumed to be the body's abnormal autoimmune response to the altered intestinal microbiome. Like most autoimmune diseases, it can be considered multifactorial, and to this day we do not know a single underlying cause, nor an exact genetic background, nor a general characteristic immunological deviation that can be identified. What can clearly contribute to the development of the disease is the consumption of harmful substances from the environment. This is supported by the treatment strategy for Crohn's disease, the most common form of IBD in childhood, which initially consists of a strict diet. In Crohn's disease and in the other type of IBD, ulcerative colitis, it is more often necessary in addition to the general immunsuppressive treatment, especially in childhood, to perform so-called biological therapies that selectively inhibit inflammatory mechanisms. Biological therapy provides an opportunity to spare steroids, which have many side effects, and even general immunosuppressive treatment, and as a gut-saving procedure, it also reduces the need for surgical resection. With the help of therapeutic drug level and antibody level monitoring, which are now also available in Hungary, it is possible to proactively intervene in the optimization of therapy before symptoms develop, to achieve a better quality of life.