Scandinavian Journal of Gastroenterology最新文献

{"title":"Prevalence and risk factors of musculoskeletal symptoms among treated coeliac disease patients.","authors":"Saara Tillqvist, Saana Paavola, Camilla Pasternack, Heini Huhtala, Teea Salmi, Kalle Kurppa, Katri Kaukinen, Pilvi Laurikka","doi":"10.1080/00365521.2025.2560000","DOIUrl":"https://doi.org/10.1080/00365521.2025.2560000","url":null,"abstract":"<p><strong>Objective: </strong>Varying musculoskeletal symptoms, such as joint pain and myalgia, are recognized as possible extraintestinal complaints of coeliac disease (CeD), but little is known about the prevalence and risk factors of these symptoms. In this study the aim was to evaluate the prevalence of and factors associated with self-reported musculoskeletal symptoms among adult CeD patients on a gluten-free diet (GFD).</p><p><strong>Materials and methods: </strong>The presence of current musculoskeletal symptoms was studied in 614 CeD patients on a GFD and 539 of their non-CeD relatives by a systematic interview. The association between musculoskeletal symptoms and various patient-related factors was investigated using logistic regression.</p><p><strong>Results: </strong>CeD patients reported more often current musculoskeletal symptoms than controls (37.8% vs. 22.8%, <i>p</i> < 0.001). CeD was an independent risk factor for musculoskeletal symptoms even after adjusting for age, gender and previously diagnosed co-morbidities, including autoimmune thyroid disease, osteoarthritis and osteoporosis/osteopenia (odds ratio 1.95, 95% confidence interval 1.48-2.59). Factors associated with these symptoms were female sex, higher age at present, long duration of any CeD-related symptoms before diagnosis and presence of autoimmune thyroid diseases and osteoarthritis.</p><p><strong>Conclusion: </strong>CeD is associated with musculoskeletal symptoms even on a strict GFD. Possible susceptibility to current musculoskeletal complaints should be kept in mind, especially among certain risk patients such as those with long diagnostic delay and osteoarthritis.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for mucosal cytomegalovirus infection and specific endoscopic features in patients with ulcerative colitis.","authors":"Chao Ye, Wenyuan Li, Xie Li, Qiuxia Jiang, Wei Li","doi":"10.1080/00365521.2025.2558970","DOIUrl":"https://doi.org/10.1080/00365521.2025.2558970","url":null,"abstract":"<p><strong>Background: </strong>The role of cytomegalovirus (CMV) in ulcerative colitis (UC) remains controversial. This study aimed to evaluate the association between mucosal CMV load and disease severity and to identify predictive risk factors for CMV infection in active UC.</p><p><strong>Methods: </strong>Mucosal CMV DNA load was quantified by real-time PCR in 231 patients with active UC. Disease activity was assessed using the Truelove & Witts clinical score, Mayo endoscopic subscore, and a modified Geboes score for histologic evaluation. Multivariate logistic regression was used to identify independent risk factors.</p><p><strong>Results: </strong>CMV was detected in the colonic mucosa of 91 patients (39.4%). Patients with CMV infection showed significantly higher clinical (<i>p</i> < 0.001) and endoscopic severity (<i>p</i> = 0.002). The prevalence of CMV infection showed a positive trend with higher clinical disease activity (<i>p</i> < 0.001) and was also associated with more severe endoscopic (<i>p</i> = 0.002) and histologic inflammation (<i>p</i> = 0.004). Mucosal CMV load strongly correlated with clinical severity (ρ = 0.498, <i>p</i> < 0.001) and histologic grade (ρ = 0.735, <i>p</i> < 0.001). ROC analysis indicated that CMV load effectively predicted severe clinical (AUC = 0.796), endoscopic (AUC = 0.697), and histologic disease (AUC = 0.905; all <i>p</i> < 0.01). Multivariate analysis identified cobblestone-like appearance, punched-out ulcers, spontaneous bleeding, and decreased absolute lymphocyte count as independent predictors of CMV infection.</p><p><strong>Conclusion: </strong>Mucosal CMV load is closely associated with inflammatory severity in UC. Characteristic endoscopic features and lymphopenia may serve as valuable predictors for CMV infection.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between invasive and noninvasive liver disease assessments and long-term clinical outcomes in MASLD.","authors":"Ying Shang, Johan Vessby, Kamal Kant Mangla, Riku Ota, Marc Künkel Winther, Mattias Ekstedt, Hannes Hagström","doi":"10.1080/00365521.2025.2555911","DOIUrl":"https://doi.org/10.1080/00365521.2025.2555911","url":null,"abstract":"<p><strong>Background and aims: </strong>Data are limited on how histology and noninvasive tests (NITs) for fibrosis severity in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) can predict future events. We aimed to confirm the prognostic capacity of liver fibrosis to predict major adverse liver outcomes (MALO), and to confirm previous findings of similar prognostic capacity between invasive and noninvasive fibrosis tests on long-term outcomes.</p><p><strong>Methods: </strong>This longitudinal observational cohort study (1974-2020) used data from adults with biopsy-defined MASLD from three Swedish university hospitals linked to national registers. Risks for MALO and major adverse cardiovascular events (MACE) were estimated using multivariable adjusted Cox regression models.</p><p><strong>Results: </strong>Median (mean) follow-up for the overall population (<i>N</i> = 959) was 11 (15) years; 103 (10.7%) developed MALO and 245/867 patients without baseline cardiovascular disease (28.3%) developed MACE. The risk of long-term MALO was significantly lower in patients at fibrosis stage F0, F1 and F2, compared with F4, but not between stages F3 and F4. No significant associations were observed between other histological features and incident MALO. Neither fibrosis stage nor histological features were significantly associated with incident MACE. Biopsy-defined fibrosis staging and Fibrosis-4 Index (FIB-4) scoring had similar predictive performance with unadjusted C-index (95% confidence interval) values for MALO of 0.77 (0.71-0.82) and 0.75 (0.69-0.80) and for cardiovascular-related outcomes 0.58 (0.53-0.60) and 0.65 (0.61-0.68), respectively.</p><p><strong>Conclusions: </strong>These data confirm the importance of liver fibrosis as the main predictor of long-term MALO. FIB-4 may aid in risk assessment and in predicting outcomes in MASLD.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-12"},"PeriodicalIF":1.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in prevalence and incidence of inflammatory bowel disease over 30 years: a population-based cohort study, the HUNT study.","authors":"Heidi Hjelle, Tor Åge Myklebust, Atle van Beelen Granlund, Ann Elisabeth Østvik, Eivind Ness-Jensen","doi":"10.1080/00365521.2025.2555920","DOIUrl":"https://doi.org/10.1080/00365521.2025.2555920","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of inflammatory bowel disease (IBD) is rising, while the incidence varies between countries.</p><p><strong>Objective: </strong>To determine changes in prevalence and incidence of IBD in a Norwegian general population.</p><p><strong>Design: </strong>This study was based on the Trøndelag Health Study (HUNT), a series of population-based health surveys in Nord-Trøndelag County, Norway, conducted since the 1980s. All adult residents aged 20 years and above were invited. The total number of unique participants in HUNT is 123,000. Those diagnosed with IBD were identified and verified by linkage to hospital records. Annual age-standardized prevalence and incidence rates were calculated from 1990 to 2022.</p><p><strong>Results: </strong>The prevalence of IBD was 0.22% in 1990, increasing to 1.6% in 2022. An increase in ulcerative colitis (UC) accounted for the largest rise, from 0.16% to 1.12%. The prevalence of Crohn's disease (CD) rose from 0.06% to 0.27%. IBD unclassified (IBDU) was rarely diagnosed in the early years of the study but accounted for 0.19% in 2022. The incidence of IBD showed an average annual increase of 0.72% in the observation period. This was mainly due to an increase in UC in women, while the incidence was relatively stable in men. The incidence of IBD was highest, but stable, for those under 30 years, while the incidence rose in the older age groups, mostly in those above 70 years.</p><p><strong>Conclusion: </strong>In this Norwegian adult population, the prevalence of IBD has been high and rising over the last 30 years. It is the highest prevalence of IBD reported in Europe.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of postoperative CRP levels for endoscopic recurrence in patients with Crohn's disease undergoing ileocolic resection.","authors":"Anouck E G Haanappel, Caroline van Tieghem de Ten Berghe, Mahsoem Ali, Albert M Wolthuis, Malaika S Vlug, Willem A Bemelman, Andre D'Hoore, Christianne J Buskens, Gabriele Bislenghi","doi":"10.1080/00365521.2025.2553885","DOIUrl":"https://doi.org/10.1080/00365521.2025.2553885","url":null,"abstract":"<p><strong>Background and aims: </strong>Patients with Crohn's disease (CD) undergoing ileocolic resection (ICR) develop higher postoperative C-reactive protein (CRP) levels compared to colorectal cancer (CRC) patients, suggesting an increased postoperative inflammatory response. This study investigates whether postoperative C-reactive protein (CRP) levels are associated with endoscopic recurrence (ER) after ICR.</p><p><strong>Methods: </strong>All CD patients who underwent ICR between 2007 and 2022 at two referral centers were identified from prospectively maintained databases. Those with endoscopic follow-up within 12 months postoperatively were included. ER was defined as modified Rutgeerts score (mRs) ≥i2b. The primary outcome was the association between postoperative CRP levels and ER. Secondary outcomes were the added prognostic value of postoperative CRP levels for predicting ER, adjusted for traditional risk factors.</p><p><strong>Results: </strong>Among 542 patients, 36% had penetrating disease, 24% were active smokers, and 11% received prophylactic advanced therapies. ER was observed in 243/542 (45%). Patients with ER had higher CRP levels on postoperative day (POD) 2-5, with a significant difference on POD 4 (median CRP, 122 mg/L vs 97 mg/L; adjusted mean difference, 16% [1 to 26%]). After adjusting for traditional risk factors, CRP levels on POD 4 remained an independent predictor of ER (<i>p</i> = 0.022) and improved the AUC of a model with traditional risk factors by 0.04 (95% CI, 0.02-0.09; <i>p</i> = 0.0005).</p><p><strong>Conclusion: </strong>Elevated CRP levels on POD 4 in CD patients undergoing ICR were associated with an increased risk of ER within 12 months. In combination with other known risk factors, CRP could serve as a marker to identify patients benefitting from closer postoperative monitoring.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of liver histology and fibrosis-4 scoring as tools for evaluating healthcare resource utilization and costs in patients with MASLD: a Swedish cohort study.","authors":"Emilie Toresson Grip, Kamal Kant Mangla, Riku Ota, Marc Künkel Winther, Ying Shang, Helena Skröder, Johan Vessby, Stergios Kechagias, Hannes Hagström","doi":"10.1080/00365521.2025.2553284","DOIUrl":"https://doi.org/10.1080/00365521.2025.2553284","url":null,"abstract":"<p><strong>Objectives: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is associated with substantial clinical and economic burden. Fibrosis detection is key to disease management, but biopsy-defined staging is invasive, expensive, and associated with complications. We evaluated healthcare resource utilization (HCRU) and costs by disease stage using biopsy-defined staging and fibrosis-4 (FIB-4; a simple, well-validated, non-invasive tool for assessing fibrosis severity), and compared their utility for predicting long-term outcomes in MASLD.</p><p><strong>Methods: </strong>This longitudinal observational cohort study included 959 adults with biopsy‑defined MASLD in Swedish medical records (1974-2020) linked to national registers. Patients had a documented fibrosis stage (F0-F4) and age-stratified FIB-4 score (low, indeterminate, high) at baseline. All-cause, liver-, and cardiovascular (CV)-related HCRU/costs were evaluated. The predictive capacity of biopsy and FIB-4 for high HCRU (≥80th percentile of hospitalizations + outpatient visits) was assessed using Harrell's concordance index.</p><p><strong>Results: </strong>In general, patients with advanced fibrosis had significantly more all-cause and liver-related hospitalizations, longer length of stay, and higher costs than patients with less advanced fibrosis. The number and cost of liver-related outpatient visits increased significantly as fibrosis severity increased, a trend also observed when comparing high and low FIB-4 scores. Other HCRU/cost outcomes were inconsistent between scoring approaches. No association was found between CV-related HCRU and fibrosis severity. Biopsy and FIB-4 demonstrated similar predictive capacity for identifying patients with high HCRU.</p><p><strong>Conclusions: </strong>These data highlight the positive association between fibrosis severity and HCRU and costs in MASLD, and suggest that FIB-4 may have similar utility to biopsy for evaluating certain HCRU outcomes.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-16"},"PeriodicalIF":1.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel prediction model of mortality in chronic pancreatitis using clinical characteristics and gene promoter hypermethylation status.","authors":"Benjamin Stubbe, Inge Søkilde Pedersen, Poul Henning Madsen, Henrik Bygum Krarup, Søren Schou Olesen, Ole Thorlacius-Ussing, Stine Dam Henriksen","doi":"10.1080/00365521.2025.2554345","DOIUrl":"10.1080/00365521.2025.2554345","url":null,"abstract":"<p><strong>Background: </strong>Chronic pancreatitis (CP) is an inflammatory disease characterized by pain, functional deficits and increased mortality. The clinical course is unpredictable, and there are no classification systems or biomarkers to predict this. Identifying patients with high mortality risk is crucial for guiding clinical management and improving outcomes. This study presents a novel approach to a prognostic prediction model that combines clinical parameters and promoter hypermethylation (ph) of genes.</p><p><strong>Methods: </strong>We performed methylation-specific quantitative polymerase chain reaction(qPCR) on a panel of 28 genes, using an accelerated bisulfite treatment protocol. We then developed a prognostic prediction model by backwards stepwise elimination using the methylation status of genes with a ph frequency > 5% and seven clinical factors. Survival was assessed with Kaplan-Meier survival curves and Cox regression.</p><p><strong>Results: </strong>Ninety-seven patients with CP were included in the study. The final model included: Age, sex, exocrine insufficiency, diabetes, prior history of acute pancreatitis, and the methylation status of MLH1, HIC1, and RASSF1A. The model had an area under the curve (AUC) of 0.84 (95%CI: 0.76-0.92). A risk score was computed, and patients stratified into high and low-risk groups. The high-risk group had a significantly higher hazard ratio (HR) of death of 14.1 (95% CI; 4.3-46.0, <i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>This study serves as proof-of-concept that clinical factors can be combined with gene methylation status to provide additional prognostic information in patients with chronic pancreatitis. This could potentially aid the clinician in estimating which patients require intense follow-up. However, external validation is required.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-10"},"PeriodicalIF":1.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A decade of patient-derived organoids in pancreatic cancer: points in translation.","authors":"Marcus T Roalsø, Daniel Öhlund, Kjetil Søreide","doi":"10.1080/00365521.2025.2555701","DOIUrl":"https://doi.org/10.1080/00365521.2025.2555701","url":null,"abstract":"","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-3"},"PeriodicalIF":1.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Rockall Score and Revised Rockall Score for predicting outcomes in nonvariceal upper gastrointestinal bleeding.","authors":"Yan-Yan Zhang, Qiao-Xian Zhang, Ze-Hao Zhuang, Ting-Ting Lian, Jia-Yuan Zhuang","doi":"10.1080/00365521.2025.2538758","DOIUrl":"10.1080/00365521.2025.2538758","url":null,"abstract":"<p><strong>Background: </strong>The Rockall score (RS) is used to assess the prognosis of patients with nonvariceal upper gastrointestinal bleeding. Aims: To establish the Revised Rockall Score (RRS) that incorporates an assessment of endoscopic treatment results, and analyze the discriminative ability of the RRS for 30-day rebleeding and mortality in patients with nonvariceal upper gastrointestinal bleeding.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 432 patients between January 2016 and December 2019 (derivation cohort), and further evaluated in an independent population of 290 patients between January 2020 and December 2022 (validation cohort). Clinical records and biological data were collected. The outcome variables were rebleeding and mortality, whereas the explanatory variables were the RS and RRS. The predictive accuracy of the two scoring systems was evaluated using the receiver operating characteristic curve (AUROC).</p><p><strong>Results: </strong>In the derivation cohort, the RRS achieved a higher area under the AUROC for predicting rebleeding (AUROC: RS, 0.75; RRS, 0.88; <i>p</i> < 0.0001), mortality (AUROC: RS, 0.87; RRS, 0.94; <i>p</i> = 0.001), and rebleeding and/or mortality (AUROC: RS, 0.78; RRS, 0.90; <i>p</i> < 0.0001) than the RS. In the validation cohort, the RRS also achieved a higher AUROC for predicting rebleeding (AUROC: RS, 0.80; RRS, 0.89; <i>p</i> < 0.001), mortality (AUROC: RS, 0.79; RRS, 0.89; <i>p</i> = 0.004), and rebleeding and/or mortality (AUROC: RS, 0.80; RRS, 0.91; <i>p</i> < 0.001) than the RS.</p><p><strong>Conclusions: </strong>Compared to the RS, the RRS had higher discriminative ability in predicting the risk of rebleeding and mortality.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"879-888"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144744575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and environmental impact of intestinal ultrasound for inflammatory bowel disease: a tertiary centre experience in Southeast Asia.","authors":"Yi Yuan Tan, Elizabeth Hui Ting Cheong, Chong Teik Lim, Sihui Cai, Shu Wen Tay, Justin Wen Hao Leong, Ennaliza Salazar, Lionel Tim-Ee Cheng, Albert Su Chong Low, Malcolm Teck Kiang Tan","doi":"10.1080/00365521.2025.2533338","DOIUrl":"10.1080/00365521.2025.2533338","url":null,"abstract":"<p><strong>Objectives: </strong>Inflammatory bowel disease (IBD) is a chronic relapsing disease primarily affecting the gastrointestinal tract, comprising mainly of ulcerative colitis and Crohn's disease. Intestinal ultrasound (IUS) evaluates transmural healing, which is associated with better clinical outcomes. The aims of this study were to determine the influence of IUS on clinical management decisions and evaluate cost and carbon emission reductions when colonoscopies and magnetic resonance enterography (MRE) were avoided.</p><p><strong>Methods: </strong>Eligible patients 18 years and older with established diagnosis of IBD within nine months. Patients seen in IBD outpatient clinics were offered IUS and followed up within two weeks, with evaluation of whether they were in clinical, biochemical and/or transmural remission. We determine clinical, biochemical and sonographic concordance for each IUS assessment and subsequent impact on clinical management.</p><p><strong>Results: </strong>Out of 60 IUS assessments for 48 unique patients, 38 (63.3%) and 19 (31.7%) were in clinical and transmural remission, respectively. Of the 38 in clinical remission, 18 (47.4%) were in transmural remission. All but one with clinically active disease were not in transmural remission. There was moderate correlation between clinical and transmural remission. Discordant IUS findings were significantly associated with therapy escalation; 63.3 - 65% of patients who underwent IUS avoided endoscopy/MRE. Total cost savings amounted to US$ 92,069; total reduction in carbon emissions was 2752 kg CO₂e.</p><p><strong>Conclusion: </strong>IUS is a valuable, cost effective and environmentally friendly investigation superior to MRE and endoscopy in evaluating transmural disease and has the potential to alter clinical decisions based on detection of transmural activity.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"889-899"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}