Diagnosis and treatment of Inflammatory Bowel Disease in 2022

Abstract

Since the first report of a disease that today we call ulcerative colitis at the end of the 18th century, the knowledge in Inflammatory Bowel Disease (IBD) has radically changed. From using tuberculostatics to treat Crohn’s disease and rectal irrigations in ulcerative colitis, to developing specific drugs targeted to specific molecules, our pharmacological, endoscopic, and surgical tools have evolved and allowed us to treat its severe and challenging variants, traditionally considered to be fatal. Much of the credit of our success controlling these conditions comes from a better understanding of the complex underlying immune alterations and permanent inflammation that cause them; and maybe, one of the greatest achievements in IBD has been the design of the so-called biologic therapy. Moreover, the development of clinical tests to detect inflammatory activity in blood and stool, the apparition of new ways of detecting premalignant lesions and minimal invasive therapy for complications, and new surgical strategies have let us to individualize treatment and monitoring the disease and improve life quality in our patients. However, we still find lots of diagnostic and treatment challenges in IBD in our daily practice, today. We present our review of the management of Crohn’s disease, ulcerative colitis, and indeterminate colitis in 2022.