1. Panel: youth and Education
Maurizio Vecchi, M.D.
University of Milan

2. IBD are challenging diseases
……from the beginning….
…..through their entire course….

3. The onerous course of the disease
Difficult to diagnose (long delay in diagnosis)
Life-time duration
Need for maintenance therapy
Frequent relapses
Many extraintestinal complications
Frequent, complex surgery
Disease and drug-related cancers

4. Adolescence is a very difficult time
of our life……
With a strong request for (and fear of) freedom
With a recognition of personal duties but a low consideration of them
With a struggle to set his/her own independence
With many uncertainties

5. Imagine the impact of such diseases on an adolescent -1-
Pains and suffering
Embarassing symptoms
Limitations
Needs
Duties
Confusing perspectives for future health

6. Imagine the impact of such diseases on an adolescent -2-
Difficulties at coping with the disease, at school, at work, with friends, with the boy (girl)-friend
High risk of depression, anxiety, social isolation, altered self-image
Difficult relationships with parents and doctors

7. As a consequence…
Very difficult to evaluate the real clinical condition
Very low compliance to diagnostic tests and
therapies
Far from an ideal management of the disease
Worsening of the clinical and psychological situation

8. Epidemiological trends
Diagnosis of IBD among young or very young subjects is becoming more frequent:
Stockholm CD 9.1/ /y
UC 2.8/ /yr
60 % of studies report increase in pediatric CD incidence
20 % of studies report increase in pediatric UC incidence
Diffuse finding (Sweden, China, Finland, Scotland, Denmark, USA, Italy)
Young patients frequently have panenteritis

9. Epidemiological trends
The course of early-onset IBD is suggested to be rather unfavourable
Diagnosis in young subjects suggests an important role of genetic factors

10. What to do
Favour the knowledge of the disease by the young patients emphasizing the possibility of a favourable course, when disease is well managed.
Organize specific supports at school and at work for young patients with aggressive IBD.
Favour the sharing of disease experience among patients (EFCCA, AMICI, etc.).
Identify patients with impaired quality of life and implement strategies that may improve it, so that they may have an easier transition to adulthood while living with IBD.