 This study examined very early onset inflammatory bowel disease, the OIBD, in children aged less than six years. The results showed that approximately 30-40% of these children had underlying immunodeficiency states. Additionally, gastroscopy and colonoscopy were performed in all patients, along with basic workup for associated immunodeficiencies and molecular genetics. This article was authored by Huma Arshad Chima, Nadia Waheed, Anjum Saeed, and others.