P-ECCO

Growth impairment remains one of the most distinctive and clinically significant complications of paediatric Inflammatory Bowel Disease (IBD). Unlike many other disease outcomes, impaired growth can have consequences that cannot be fully reversed once the window for linear growth has closed. Importantly, growth failure is not simply a reflection of inadequate nutrition: it is an integrated marker of inflammatory burden, nutritional status, treatment exposure and disease control.

Iva Hojsak, who has recently joined the P-ECCO Committee, is a paediatric gastroenterologist and head of the Paediatric Department and deputy director of the Children's Hospital Zagreb, Croatia. Iva graduated from the Medical School of Zagreb, where she also received her PhD. She was subsequently elected as assistant professor at University of Zagreb Medical School and University of J.J. Strossmayer Medical School.

Fatigue is increasingly recognised as one of the most distressing and disabling symptoms in children and adolescents with Inflammatory Bowel Disease (IBD). Reported by 50%–86% of patients, it often persists even during remission and can outweigh abdominal pain in its impact on daily life. Its origins are multifactorial: active inflammation, micronutrient deficiencies such as iron, vitamin B12 or folate deficiency, side effects of corticosteroids or anti-TNF therapy, poor sleep, psychological comorbidities including depression and anxiety, family dysfunction and reduced physical activity.

The European Crohn’s and Colitis Organisation (ECCO) is pleased to announce the upcoming release of new guidelines on the management of Ulcerative Colitis (UC) in paediatric patients, developed in collaboration with the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN).

The treatment of children with Inflammatory Bowel Disease (IBD) presents unique challenges, largely due to the complex nature of the disease, the limitations of existing therapies in children and the common off-label use of "newer" agents. Paediatric IBD requires careful management to control inflammation, promote growth and maintain a good quality of life. The treatment armamentarium for IBD in adults has expanded rapidly in the past several years, with the approval of new biologic and small-molecule agents for moderate-to-severe Ulcerative Colitis (UC) and Crohn’s Disease (CD) [1–3].

Iva Hojsak, who has recently joined the P-ECCO Committee, is a paediatric gastroenterologist and head of the Paediatric Department and deputy director of the Children's Hospital Zagreb, Croatia. Iva graduated from the Medical School of Zagreb, where she also received her PhD. She was subsequently elected as assistant professor at University of Zagreb Medical School and University of J.J. Strossmayer Medical School.