Inflammatory Bowel Diseases最新文献

{"title":"Reply: \"A methodological concern regarding small-sample propensity score matching and overfitting in the study of postoperative biologic strategies for Crohn's disease\".","authors":"Chunjie Zhang, Yi Li","doi":"10.1093/ibd/izag025","DOIUrl":"10.1093/ibd/izag025","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"839"},"PeriodicalIF":4.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226321","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":"Penetrating ileocolic Crohn disease with intra-abdominal abscess: diagnose, drugs, drain, divert?","authors":"Thomas M Ward, Ece Unal, Sarah Kirschling, Bhuwan Giri, Olga A Lavryk, Jeremy M Lipman, Arielle E Kanters, Michael A Valente, David Liska, Benjamin L Cohen, Stefan D Holubar","doi":"10.1093/ibd/izag030","DOIUrl":"https://doi.org/10.1093/ibd/izag030","url":null,"abstract":"<p><strong>Background: </strong>Penetrating terminal ileal Crohn disease may result in intra-abdominal abscesses prior to ileocolic resection. Literature on the perioperative management of these abscesses is scarce. We aimed to identify the association between preoperative abscess management and intraoperative and postoperative outcomes.</p><p><strong>Methods: </strong>We performed a retrospective case-control study at a single inflammatory bowel disease (IBD) referral center (2012-2022) with propensity score matching of adult patients with Crohn disease with and without abscesses who underwent ileocolic resection, as identified from a prospectively maintained database. The primary outcome was the postoperative diverting ileostomy rate; secondary outcomes included anastomotic leakage and postoperative abscess rates.</p><p><strong>Results: </strong>A total of 1372 patients were analyzed, of whom 163 (12%) had preoperative abscesses. Patients with abscesses, compared to patients without abscess, had a 1.24 relative risk (RR) of undergoing surgical diversion (95% CI, 1.14-1.34, P < .001). Patients with known abscesses not drained preoperatively, compared to no abscess, had an RR of 1.69 for diversion (P < .001, 95% CI, 1.28-2.22). Patients who had a drain removed prior to surgery had a 1.7 RR for diversion (95% CI, 1-2.91, P = .05). However, patients who had a drain placed and kept until surgery did not have a significantly different rate of diversion compared to those without an abscess (P = .16).</p><p><strong>Conclusions: </strong>Penetrating terminal ileitis with abscesses was associated with adverse outcomes after ileocolic resection for Crohn disease. Optimal management includes preoperative diagnosis with repeated imaging at appropriate intervals preoperatively, antibiotic therapy, percutaneous drainage when indicated with maintenance of the drain until surgery, and selective diversion.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581249","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":"Correction to: Safety and outcomes of advanced IBD therapies in patients with HIV: a propensity-matched cohort analysis.","authors":"","doi":"10.1093/ibd/izag044","DOIUrl":"https://doi.org/10.1093/ibd/izag044","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521095","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":"Discordant Clostridioides difficile testing as a predictor of inflammatory bowel disease therapy escalation.","authors":"Pavithra Ramakrishnan, James Campbell, Daphne Moutsoglou, Megan Ghai, Eugenia Shmidt, Byron P Vaughn","doi":"10.1093/ibd/izag038","DOIUrl":"https://doi.org/10.1093/ibd/izag038","url":null,"abstract":"<p><strong>Background: </strong>In patients with inflammatory bowel disease (IBD), Clostridioides difficile infection (CDI) presents with clinical features indistinguishable from the underlying disease. Sequential polymerase chain reaction (PCR) and enzyme immunoassay (EIA) testing reduce overdiagnosis; however, discordant results create management uncertainties.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of IBD patients with positive C. difficile PCR testing at 2 institutions between April 2022 and December 2023. Patients were stratified by EIA toxin (TOX) results. Demographic, clinical, laboratory, and therapeutic data were extracted, and outcomes assessed included CDI-directed therapy or escalation of IBD treatment.</p><p><strong>Results: </strong>Of 575 IBD patients tested, 117 met inclusion criteria. Among them, 79% (93/117) were PCR+/TOX- and 21% (24/117) were PCR+/TOX+. PCR+/TOX+ patients had significantly higher CRP (98 vs 6 mg/L, P = .005). PCR+/TOX- patients had more severe underlying IBD and higher rates of steroid use (48% vs 21%, P = .02) and were less likely to receive CDI treatment (72% vs 96%, P = .01) but were significantly more likely to require IBD therapy escalation (54% vs 25%, P = .004). Multivariable analysis showed PCR+/TOX- status (odds ratio [OR], 3.2; P = .045) and moderate-to-severe endoscopic disease within 1 year of testing (OR, 5.6; P = .0007) were significant predictors of IBD treatment escalation.</p><p><strong>Conclusions: </strong>Elevated CRP may help distinguish true CDI in IBD. PCR+/TOX+ patients typically respond to CDI-directed therapy, whereas PCR+/TOX- patients more often require escalation of IBD treatment, suggesting noninfectious inflammation as the primary driver of symptoms.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511673","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":"Enhancing Inflammatory Bowel Disease (IBD) competency in gastroenterology fellowship through traditional, digital, and experiential learning pathways.","authors":"Aimen Farooq, Mariam Naveed, Reezwana Chowdhury, Jennifer Seminerio, Joseph Sleiman","doi":"10.1093/ibd/izag043","DOIUrl":"https://doi.org/10.1093/ibd/izag043","url":null,"abstract":"<p><p>The rapidly evolving field of Inflammatory Bowel Disease (IBD) places growing educational demands on gastroenterology trainees, many of whom report gaps in confidence and preparedness in managing IBD across diverse clinical settings. This article provides a practical, inclusive framework to support gastroenterology fellows in achieving core competency in IBD care while outlining scalable pathways for those interested in developing specialized expertise. Traditional resources such as major conferences, society guidelines, consensus statements, and peer-reviewed journals form the foundation of evidence-based training. Equally vital, however, are opportunities to refine cross-disciplinary skills through close collaboration with radiology, pathology, and endoscopy teams. Visiting observerships at leading IBD centers can be pivotal for immersive, hands-on exposure to complex case management and multidisciplinary care models. The article highlights a growing array of digital and longitudinal learning platforms including webinars, educational websites, podcasts, and programs such as virtual grand rounds, IBD Live, IBD-EII, and IBD REACH that offer flexible, accessible, and globally connected learning experiences. Additionally, it underscores the importance of mentorship, leadership development, and institutional support from program directors in fostering individualized IBD training tracks. By integrating traditional educational foundations with innovative, accessible non-traditional resources and platforms, this guide positions IBD training within a framework of inclusivity, equity, and lifelong learning.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493802","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":"Disease reprogression following surgical resection in Crohn disease.","authors":"Sara Ghoneim, Quinten Dicken, Mmeyeneabasi Omede, Hailey Harris, Cindy C Y Law, Ashwin N Ananthakrishnan","doi":"10.1093/ibd/izag035","DOIUrl":"https://doi.org/10.1093/ibd/izag035","url":null,"abstract":"<p><strong>Background: </strong>Ileocecal resection (ICR) for stricturing (B2) or internal penetrating (B3) phenotypes of Crohn disease (CD) is associated with higher rate of recurrence. Whether patients are at an increased risk of reprogression to complicated behavior (B2/B3) after index surgery remains unknown.</p><p><strong>Methods: </strong>This retrospective study included adult patients with CD who underwent ICR during 1990-2020. We extracted disease characteristics, preoperative and postoperative treatments. The primary outcome was reprogression to B2/B3 disease following ICR. Multivariable logistic regression was used to assess the association between preoperative phenotype and postoperative disease behavior, adjusting for confounders.</p><p><strong>Results: </strong>Our study included 297 patients with CD who underwent ICR between 1990-2020. Over half (52%) were male, the mean age at surgery was 36 years, and the mean disease duration was 15 years. At resection, disease phenotypes were B1 (nonstricturing, nonpenetrating) in 20%, B2 in 54%, and B3 in 25%. Postoperatively, 56% of patients received advanced therapy. After a median follow-up period of 14 years, 73% of patients had B1, 23% developed B2, and 4% developed B3 disease. Disease reprogression to B2/B3 disease was independent of preoperative disease behavior (P = .90) with 68%, 74%, and 75% of patients whose disease was B1, B2, or B3 at surgery, respectively, having their disease reclassified as B1 at last follow-up. Only 3% of those who underwent surgery for B3 redeveloped B3 disease.</p><p><strong>Conclusions: </strong>Recurrence of stricturing or penetrating complications following an initial ileocecal resection is independent of preoperative phenotype in CD under contemporary CD management.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480458","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":"Recovery of response and long-term outcomes following loss of response and dose escalation of subcutaneous infliximab: a post hoc analysis of the LIBERTY-CD & LIBERTY-UC trials.","authors":"Marla C Dubinsky, Stefan Schreiber, Andres J Yarur, Bruce E Sands, Stephen B Hanauer, Silvio Danese, Hyunseong Yu, Dong-Hyeon Kim, Young Nam Lee, Jean-Frédéric Colombel","doi":"10.1093/ibd/izag017","DOIUrl":"https://doi.org/10.1093/ibd/izag017","url":null,"abstract":"<p><strong>Background: </strong>Rapidity of onset of efficacy following dose escalation of subcutaneous infliximab after loss of response remains unclear in Crohn's disease (CD) and ulcerative colitis (UC). This post hoc analysis of the LIBERTY-CD and LIBERTY-UC trials evaluated time to response recovery following dose escalation of subcutaneous infliximab after loss of response, and characterized patients who experienced early recovery.</p><p><strong>Methods: </strong>This analysis included week 10 responders to intravenous infliximab induction who were randomized to receive subcutaneous infliximab 120 mg every other week (Q2W) and underwent dose escalation to 240 mg Q2W following loss of response. Time to response recovery was assessed, and outcomes pre-/post-dose escalation were analyzed by recovery timing (early [≤8 weeks], late [>8 weeks], non-recovery). Week 102 outcomes and factors associated with early recovery were evaluated.</p><p><strong>Results: </strong>Response recovery was achieved in 85.1% (40/47) with CD and 82.3% (51/62) with UC, with early recovery in 66.0% (31/47) and 69.4% (43/62), respectively. Early recovery groups in CD and UC showed greater serum infliximab increases than late or non-recovery groups. At week 102, numerically higher rates of clinical response and clinical remission in CD, and endoscopic remission in UC, were observed in early versus late recovery group. Factors associated with early recovery differed between CD and UC: systemic inflammatory and pharmacokinetic parameters were linked to early recovery in CD, while mucosal and gut-specific factors predominated in UC.</p><p><strong>Conclusion: </strong>Dose escalation of subcutaneous infliximab led to rapid response recovery in most patients with CD and UC. Early recovery was associated with favorable long-term outcomes.</p><p><strong>Clinical trial registration numbers: </strong>NCT03945019 and NCT04205643.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480393","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":"Impact of visceral adipose tissue and skeletal muscle on early and long-term biologic treatment failure in Crohn's disease: A multicenter retrospective cohort study.","authors":"Qiong Guo, Quanrongzi Wang, Jie Chen, Meijiao Lu, Xiaojing Zhao, Jingjing Ma, Chunhua Jiao, Nana Tang, Hongjie Zhang","doi":"10.1093/ibd/izag023","DOIUrl":"https://doi.org/10.1093/ibd/izag023","url":null,"abstract":"<p><strong>Background: </strong>Crohn's disease (CD) patients exhibit changed body composition, with elevated visceral adipose tissue (VAT) and reduced skeletal muscle (SM). This study aimed to investigate the impact of VAT and SM on the efficacy of CD biologics and develop a predictive model for loss of response.</p><p><strong>Methods: </strong>This was a multicenter retrospective cohort study. CD patients initially treated with infliximab and ustekinumab were enrolled between January 2018 and December 2023. The visceral fat index (VFI) and skeletal muscle index (SMI) were measured using computed tomography. Patients were divided into 3 groups based on tertiles of VFI (quartile 1 [Q1]: <0.575; Q2: 0.575-0.885; Q3: ≥0.885) and SMI (Q1: <36.4; Q2: 36.4-44.4; Q3: ≥44.4). The primary outcome was loss of response at 52 weeks and the secondary outcome was primary nonresponse after induction.</p><p><strong>Results: </strong>A total of 248 patients were included. The lowest SMI group had higher rates of primary nonresponse (Q1 vs Q2 vs Q3: 15.7% vs 7.2% vs 3.7%; P = .021) and loss of response (Q1 vs Q2 vs Q3: 38.0% vs 17.1% vs 16.5%; P < .001). Higher VFI was linked with increased loss of response (Q1 vs Q2 vs Q3: 12.8% vs 17.1% vs 41.7%; P < .001) and lower mucosal healing rates (Q1 vs Q2 vs Q3: 63.9% vs 40.0% vs 26.9%; P < .001). Elevated VFI (male >0.887, female >0.679) and reduced SMI (male <40.2, female <31.0) were independent risk factors for 52-week loss of response. A predictive model combining body composition parameters and clinical data showed strong performance, with an externally validated area under the curve of area under the curve of 0.902 (95% confidence interval, 0.828-0.975).</p><p><strong>Conclusions: </strong>Elevated VAT and reduced SM were associated with loss of response in CD biologics. The predictive model integrating body composition parameters demonstrated good performance.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468048","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":"Preoperative anorectal manometry is associated with cuffitis but not proximal pouch inflammation after IPAA creation.","authors":"Emma Dester, Joseph Carter Powers, Mark Zemanek, Riley Smith, Zeeyong Kwong, Anna Spivak, Benjamin L Cohen, Katherine Falloon, Tracy Hull, Bret Lashner, Cheryl Cameron, Taha Qazi","doi":"10.1093/ibd/izag027","DOIUrl":"https://doi.org/10.1093/ibd/izag027","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing ileal pouch-anal anastomosis (IPAA) for inflammatory bowel disease (IBD) commonly experience postoperative inflammatory complications, including pouchitis and cuffitis. While pelvic floor dysfunction has been associated with these complications, the predictive value of preoperative anorectal manometry (ARM) remains unclear. We evaluated the association between abnormal preoperative ARM and postoperative inflammatory outcomes in IPAA patients.</p><p><strong>Methods: </strong>In this historical cohort study we assessed IPAA patients who underwent preoperative ARM with ileostomy closure during the period from January 2009 to December 2024. Patients were divided into 2 groups-normal vs abnormal pelvic floor function-based on ARM. Primary outcomes were a composite measure of endoscopic inflammatory pouch disease (EIPD) and endoscopic evidence of rectal cuffitis after the perioperative period. Secondary outcomes included individual components of the composite primary outcome. Multivariable logistic regression was used to assess associations while controlling for covariates.</p><p><strong>Results: </strong>We included 179 patients in this study, 46 (25.7%) with abnormal ARM and 133 (74.3%) with normal ARM. In multivariable regression, abnormal ARM was associated with modestly increased odds of cuffitis (odds ratio [OR], 2.136; 95% CI, 1.050-4.345; P = .037) but was not associated with EIPD (OR, 1.490; 95% CI, 0.710-3.104; P = .287). Secondary outcomes were similar between groups, except for diffuse pouch inflammation, which was more frequently observed among patients with abnormal ARM (P = .024).</p><p><strong>Conclusions: </strong>Abnormal preoperative ARM was associated with increased odds of postoperative cuffitis but not composite endoscopic pouch inflammation in IPAA patients. Given the modest effect size and limited precision, these findings warrant confirmation in larger, prospective studies.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147456793","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":"Artificial intelligence and the future of inflammatory bowel disease trial recruitment: from bottleneck to breakthrough.","authors":"Rohan Kakkar, Michael F Byrne","doi":"10.1093/ibd/izag036","DOIUrl":"https://doi.org/10.1093/ibd/izag036","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147456842","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}