Inflammatory Bowel Diseases最新文献

{"title":"The prevalence of abdominal computed tomography imaging findings in patients with inflammatory bowel disease who present to the emergency department: a systematic review and meta-analysis.","authors":"Althaf Azward, Gabriella Ripstein, Edgard Medawar, Sanjay Murthy, Blair Macdonald, Hans Rosenberg, Cynthia H Seow, Siddharth Singh, Jeffrey D McCurdy","doi":"10.1093/ibd/izag053","DOIUrl":"10.1093/ibd/izag053","url":null,"abstract":"<p><strong>Background: </strong>The diagnostic yield of abdominal computed tomographic (CT) imaging for patients with inflammatory bowel disease (IBD) in the emergency department (ED) is unclear. We aimed to estimate the prevalence of IBD and non-IBD pathologies detected by CT imaging in the ED.</p><p><strong>Methods: </strong>Multiple databases were systematically searched from inception until April 18, 2025. We included studies that reported abdominal CT findings among IBD patients in the ED. We estimated the prevalence of IBD and non-IBD findings using weighted proportions with 95% confidence intervals (CI). IBD-related findings were reported separately for Crohns disease (CD) and ulcerative colitis (UC), whereas non-IBD findings were pooled for both IBD subtypes.</p><p><strong>Results: </strong>Overall, 19 studies were analyzed. Among patients with CD (15 studies; n = 7681 CT scans) and UC (7 studies; n = 858 CT scans), the pooled prevalence of penetrating IBD findings were low: abscesses/inflammatory masses [CD, 12% (95% CI, 10-14); UC, 3% (95% CI, 1-6)] and perforations [CD, 3% (95% CI, 2-4); UC, 1% (95% CI, 0-2)]. Rates of other IBD findings included: inflammation [CD, 43% (95% CI, 30-57); UC, 48% (95% CI, 31-65)] and obstructions [CD, 18% (95% CI, 13-23); UC, 9% (95% CI, 1-20)]. Non-IBD pathologies were uncommon: less than 5% each for pulmonary, non-IBD gastrointestinal, or genitourinary findings.</p><p><strong>Conclusion: </strong>In this meta-analysis, we found low rates of serious penetrating IBD complications and non-IBD pathologies detected by abdominal CT in the ED. These findings suggest that more selective use of CT imaging in the ED may be warranted.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1722-1730"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: GLP‑1RAs for pouchitis in obesity: what the current study does not tell us.","authors":"Zhengwen Zhu, Huazhen Lai, Lu Chen","doi":"10.1093/ibd/izag133","DOIUrl":"10.1093/ibd/izag133","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1866-1867"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolome remodeling with reverse-engineered exclusive enteral nutrition in children with active Crohn's disease.","authors":"David L Suskind, Lucas R Hoffman, Dale Lee, Adrian J Verster, Hengqi Betty Zheng, Kendra Francis, Mason Nuding, Jairam Vanamala, Ghassan Wahbeh, Hayley Purcell, Danijel Djukovic, Daniel Raftery, Hillary S Hayden","doi":"10.1093/ibd/izag095","DOIUrl":"10.1093/ibd/izag095","url":null,"abstract":"<p><strong>Background: </strong>For children with Crohn's disease (CD), dietary therapy with exclusive enteral nutrition (EEN) is effective in achieving clinical and biochemical remission. We investigated changes in metabolites in multiple clinical sample types from children with CD following a whole foods-blended (\"reverse-engineered\") EEN formula and defined associations between these changes and remission.</p><p><strong>Methods: </strong>Stool, urine, serum, and plasma from a prospective study of newly diagnosed pediatric patients with CD enrolled in a 4-week trial of reverse-engineered exclusive enteral nutrition (RE-EEN) were analyzed using mass spectrometry targeting aqueous metabolites, bile acids, and short-chain fatty acids. Principal component analysis, mixed-effects models, and exploratory multivariate approaches including random forest and partial least-squares discriminant analysis were used to identify patterns associated with diet and metabolite abundances.</p><p><strong>Results: </strong>Fecal, urine, serum, and plasma metabolomes changed significantly during RE-EEN treatment from baseline. These global changes were largely driven by increases in amino acids and related metabolites and decreases in different amino acids and metabolites reflecting carbohydrate and purine metabolism, in all sample types. While global bile acid profiles changed with the RE-EEN diet, no changes in specific bile acid levels reached significance, and no changes were found in short-chain fatty acid concentrations.</p><p><strong>Conclusion: </strong>Metabolomic profiles for pediatric patients with CD changed broadly during RE-EEN, indicating that this therapy may modulate key systemic and gut-associated metabolic processes. The findings further suggest that the gut metabolic processes influenced by RE-EEN, and that contribute to clinical improvement, may differ from those impacted by commercial EEN diets. Further research is crucial to validate these findings, uncover causal relationships, and optimize dietary protocols to enhance therapeutic outcomes in CD.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1683-1694"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extraintestinal manifestations in Korean patients with inflammatory bowel disease: A nationwide population-based study from 2005 to 2017.","authors":"Sung Sil Park, Yun Jin Kim, Byung Kyu Ahn","doi":"10.1093/ibd/izag068","DOIUrl":"10.1093/ibd/izag068","url":null,"abstract":"<p><strong>Background: </strong>Extraintestinal manifestations (EIMs) significantly contribute to morbidity in individuals with inflammatory bowel disease (IBD); however, population-based East Asian data remain limited. We evaluated EIM burden in a nationwide Korean IBD cohort.</p><p><strong>Methods: </strong>This nationwide retrospective cohort study was conducted using data from the Korean National Health Insurance Service between 2005 and 2017. Individuals with ulcerative colitis (UC) or Crohn's disease (CD) were identified using the International Classification of Diseases-10th Edition and rare intractable disease codes. EIM incidence, associated risk factors, interval from IBD diagnosis to EIM onset, and trends by sex and age were examined.</p><p><strong>Results: </strong>Among 69 414 individuals with IBD (48 689 UC, 20 725 CD), 42.23% developed at least 1 EIM. Dermatologic manifestations were the most common (17.02%), followed by musculoskeletal (16.36%), hepatopancreaticobiliary (15.48%), and ophthalmologic (7.83%) manifestations. Low socioeconomic status, smoking history, female sex, and higher Charlson Comorbidity Index scores independently correlated with EIM development in UC (hazard ratios of 2.14, 1.18, 1.15, and 1.08, respectively) and CD (hazard ratios of 1.98, 1.20, 1.18, and 1.09, respectively). Most EIMs developed within 4 to 6 years postdiagnosis, with musculoskeletal EIMs occurring earliest (median 42.9 months [interquartile range: 10.3-89.5 months]). Annual EIM incidence increased steadily over time across all age groups.</p><p><strong>Conclusions: </strong>EIMs affected 42.23% of Korean individuals with IBD, most frequently appearing 4 to 6 years postdiagnosis. Low socioeconomic status, smoking history, female sex, and higher Charlson Comorbidity Index scores consistently correlated with EIM occurrence, and incidence increased steadily over time, highlighting the need for sustained, personalized monitoring and timely intervention.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1760-1769"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpreting oral dysbiosis during nutritional therapy in pediatric Crohn disease.","authors":"Huan Xu, Tongdong Zeng, Wen Wang","doi":"10.1093/ibd/izag149","DOIUrl":"10.1093/ibd/izag149","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1864-1865"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disentangling the gut microbiome and inflammation in inflammatory bowel diseases: longitudinal observations from the IBSEN III study.","authors":"Maria G Maseng, Simen H Hansen, Olle Grännö, Corinna Bang, Charlotte Lund, Gert Huppertz-Hauss, Gøri Perminow, Jørgen Valeur, May-Bente Bengtson, Randi Opheim, Raziye Boyar, Svein O Frigstad, Tone Bergene Aabrekk, Trond Espen Detlie, Vendel A Kristensen, Vibeke Strande, Øistein Hovde, Øyvind Asak, Andre Franke, Jonas Halfvarsson, Marte L Høivik, Johannes R Hov","doi":"10.1093/ibd/izag051","DOIUrl":"10.1093/ibd/izag051","url":null,"abstract":"<p><strong>Background and aim: </strong>Despite the well-established involvement of the gut microbiome in inflammatory bowel disease (IBD), less is known about how the gut microbiome changes over time and how it varies with clinical disease activity and fecal calprotectin (f-calprotectin). To address this gap, we utilized samples from the population-based inception cohort of the Inflammatory Bowel Disease in South-Eastern Norway III (IBSEN III) study.</p><p><strong>Methods: </strong>Data and stool samples from study participants with IBD and symptomatic controls were collected at diagnosis and after 3, 6, and 12 months. Microbiome profiling of stool samples was performed targeting the V3-V4 region of the 16S rRNA gene, and a consensus-based approach of mixed models was employed for the longitudinal microbiome analysis.</p><p><strong>Results: </strong>We included 1251 samples from 744 patients with ulcerative colitis, 618 samples from 356 patients with Crohn' s disease and 266 samples from 164 symptomatic non-IBD controls. In the IBD population, we observed that levels of f-calprotectin decreased over time, as did the patient-reported disease activity (P < .001). Distinct changes in the gut microbiome of IBD patients were observed throughout the first year, such as increased alpha diversity (P < .001) and significant taxonomic changes.Notably, there was no covariation between the changes in alpha diversity and f-calprotectin or symptom score.</p><p><strong>Conclusion: </strong>The gut microbiome during the first year after IBD diagnosis showed changes that paralleled inflammation and clinical disease activity, albeit without covariation, suggesting that there may be a disease-driving impact of gut microbiome independent of inflammation and inflammation-driven symptoms.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1695-1706"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editors.","authors":"Michael Doulberis, Stergios A Polyzos, Abbas Yadegar, Jannis Kountouras","doi":"10.1093/ibd/izag129","DOIUrl":"10.1093/ibd/izag129","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1857-1858"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148328916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five-year efficacy and safety of guselkumab for moderately to severely active Crohn's disease: Results from the phase 2 GALAXI 1 trial.","authors":"Anita Afzali, Silvio Danese, Remo Panaccione, David T Rubin, Bruce E Sands, Walter Reinisch, Julián Panés, Rian Van Rampelbergh, Nat A Terry, Leonardo Salese, Marion L Vetter, Jacqueline Yee, Christopher Corbett, Wilbert van Duijnhoven, Tadakazu Hisamatsu, Jane M Andrews, Geert R D'Haens","doi":"10.1093/ibd/izag055","DOIUrl":"10.1093/ibd/izag055","url":null,"abstract":"<p><strong>Background: </strong>The randomized, phase 2 GALAXI 1 study evaluated efficacy and safety of guselkumab, a dual-acting IL-23p19 subunit inhibitor, in participants with moderately to severely active Crohn's disease. Efficacy and safety through 5 years are reported.</p><p><strong>Methods: </strong>After completing the 48-week, treat-through GALAXI 1 main study, participants could enter the long-term extension (LTE) and continue the subcutaneous maintenance regimen assigned at randomization. Efficacy for the combined guselkumab dose groups was analyzed by (1) as-observed analysis of LTE participants, (2) nonresponder imputation (NRI) analysis of LTE participants, and (3) NRI analysis of primary efficacy analysis set (all [week 0] randomized participants). The study was not designed for statistical comparisons between groups.</p><p><strong>Results: </strong>Of 185 guselkumab-randomized participants in the primary efficacy analysis set, 151 participated in the LTE. Among those continuing treatment, with available data (as observed), 97.7% (n = 85 of 87) achieved clinical remission, 71.3% (n = 62 of 87) achieved endoscopic response, and 51.7% (n = 45 of 87) achieved endoscopic remission at week 240. Results from NRI analyses also showed durability of efficacy (eg, week-240 clinical remission: 59.2% [n = 84 of 142], LTE analysis set; 46.0% [n = 81 of 176], primary efficacy analysis set). High rates of clinical and endoscopic remission at week 240 were maintained in biologic-naive participants (97.8% [n = 45 of 46] and 54.3% [n = 25 of 46], respectively [as-observed]) and participants with an inadequate response or intolerance to biologic therapy (97.1% [n = 34 of 35] and 54.3% [n = 19 of 35], respectively [as-observed]). Event rates of serious adverse events, discontinuations due to adverse events, and serious infections were low in guselkumab-treated participants.</p><p><strong>Conclusions: </strong>Long-term guselkumab treatment showed sustained clinical and endoscopic efficacy through week 240. The long-term safety data were consistent with those previously presented in approved indications.</p><p><strong>Clinical trial registration: </strong>A Study of the Efficacy and Safety of Guselkumab in Participants With Moderately to Severely Active Crohn's Disease (GALAXI), NCT03466411, https://clinicaltrials.gov/study/NCT03466411.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1669-1682"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early transmural response assessed by intestinal ultrasound predicts long-term clinical remission in patients with IBD: Results from the TRUST BEYOND study.","authors":"Torsten Kucharzik, Ulf Helwig, Frank Seibold, Luc Biedermann, Christoph Högenauer, Imma Fischer, Leonie Hammer, Stefan Rath, Christian Maaser","doi":"10.1093/ibd/izag074","DOIUrl":"10.1093/ibd/izag074","url":null,"abstract":"<p><strong>Background: </strong>The study sought to prospectively examine clinical, biochemical, and transmural outcomes. Transmural outcomes are assessed by ultrasound after 1 year in patients with inflammatory bowel disease (IBD) treated in line with standard of care.</p><p><strong>Methods: </strong>The TRUST BEYOND study is a prospective, multicenter, noninterventional study at 49 sites in Germany, Austria, and Switzerland and includes 282 patients with IBD who have active disease at baseline. For this analysis, 163 patients with IBD (74 with Crohn's disease, 89 with ulcerative colitis) were followed up for 1 year. At baseline and at every 3 months, clinical, biochemical, and ultrasound parameters, such as bowel wall thickness and color Doppler sonography, were assessed.</p><p><strong>Results: </strong>Patients with IBD demonstrated vast improvements in clinical, biochemical, and ultrasound assessments as early as week 12. Rates of transmural response and healing progressively increased over the study period to up to 77.5% and 39.3%, respectively, in patients with ulcerative colitis and to 66.2% and 27.0%, respectively, in patients with Crohn's disease. Patients with early transmural response achieved numerically higher rates of various outcomes at week 52 than patients without early transmural response. In a multivariate analysis, transmural response at week 12 predicted clinical remission at week 52 (odds ratio, 4.3; 95% confidence interval, 2.45-7.52; P < .001).</p><p><strong>Conclusions: </strong>These results suggest that intestinal ultrasound is a suitable noninvasive modality to monitor patients with IBD in routine care. Transmural endpoints can be achieved in patients with IBD treated with standard of care and can predict outcomes after 1 year.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1770-1782"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and predictors of surgical recurrence after primary ileocolic resection in Crohn ileitis: a systematic review and meta-analysis.","authors":"Anouck E G Haanappel, Eline M L van der Does de Willebois, Mahsoem Ali, Faridi S Jamaludin, Marjolijn Duijvestein, Christianne J Buskens, Willem A Bemelman, E Joline de Groof","doi":"10.1093/ibd/izag037","DOIUrl":"10.1093/ibd/izag037","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment strategies for Crohn disease (CD) have evolved considerably over recent decades. Approximately 65% of primary resections for CD comprise ileocolic resections (ICR). Currently, up-to-date data are not available on surgical recurrence risk after primary ICR, as previous meta-analyses combined various types of intestinal resections. As such, we aimed to assess the incidence, predictors, and trends of surgical recurrence after primary ICR for CD.</p><p><strong>Methods: </strong>MEDLINE, EMBASE, and the Cochrane database were searched from inception until November 15, 2023. Studies were included if they described the surgical recurrence risk after a primary ICR for CD. The primary endpoint was surgical recurrence, defined as reoperation due to disease recurrence in the neoterminal ileum. Meta-analyses were performed to (1) evaluate trends in surgical recurrence over time, (2) estimate the risk of surgical recurrence in the biologics era (post-2000), and (3) identify risk factors for surgical recurrence.</p><p><strong>Results: </strong>Among 3498 articles screened, 55 were included, of which 31 studies reported cumulative 5- and/or 10-year surgical recurrence rates (study inclusion period: 1932-2020; n = 28 354 patients). Meta-regression analysis indicated a declining trend in both 5- and 10-year surgical recurrence rates, which stabilized after 2000. In the biologics era, pooled 5- and 10-year surgical recurrence risks were 5.7% (95% CI, 3.9-8.4) and 13.0% (8.3-19.7), respectively. Smoking, patient sex, perianal disease, and behavior were not significantly prognostic for surgical recurrence after primary ICR.</p><p><strong>Conclusion: </strong>Approximately 1 in 17 patients experience surgical recurrence within 5 years after primary ICR. The risk of surgical recurrence decreased over the past decades but has stabilized in the biologics era.</p><p><strong>Systematic review registration: </strong>PROSPERO registration No. CRD42020213027.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1815-1832"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}