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Background: Children with inflammatory bowel disease (IBD) experience extraintestinal side effects including altered body composition, impaired muscle strength, and aerobic capacity. Exercise training may remedy these issues. Purpose: To assess the feasibility, safety, participant satisfaction, and efficacy of a training program for youth with IBD. Methods: Children with IBD completed 16 weeks of training (2 supervised + 1 home sessions per week). Feasibility was assessed by tracking recruitment, adherence, and compliance rates. Safety was assessed by tracking symptoms and adverse events. Posttraining interviews gauged satisfaction. Circulating inflammatory markers, body composition, muscle strength, aerobic fitness, and habitual physical activity were measured at baseline, midtraining (8 wk), and posttraining. Results: Eleven youth were recruited and 10 completed the study. Participants adhered to 28 (1) of 32 prescribed supervised sessions and 8 (4) of 16 prescribed home sessions. There were no adverse events, and overall feedback on training was positive. Posttraining, we observed an increase in lean mass (+2.4 [1.1] kg), bone density (+0.0124 [0.015] g·cm−2), aerobic fitness (+2.8 [5.7] mL·kg LM−1· min−1), and vigorous physical activity levels (+13.09 [8.95] min·h−1) but no change in inflammation or muscle strength. Conclusion: Supervised exercise training is feasible, safe, and effective for youth with IBD and should be encouraged. [ABSTRACT FROM AUTHOR]

A prevalent symptom among Inflammatory Bowel Disease (IBD) patients is fatigue, characterized by a persistent sense of energy depletion that affects all aspects of daily life. This review aims to evaluate nursing interventions reported in the literature to alleviate fatigue in IBD patients. A comprehensive search was conducted across four electronic databases—PubMed, CINAHL, Cochrane, and Scopus—and four scientific journals: "Gastroenterology", "Inflammatory Bowel Disease", "Journal of Crohn's and Colitis", and "United European Gastroenterology Journal". Inclusion criteria were clinical trials involving adult IBD patients in remission or mild disease activity. Out of 234 studies, 2 were selected for review. These studies assess the effectiveness of Solution-Focused Therapy (SFT) that emphasizes solving problems and developing strategies for improvement, and Problem-Solving Therapy (PST) that focuses on identifying problems and coping strategies. SFT showed a positive impact on fatigue with a significant improvement in the Checklist Individual Strength after three months: 45.5% in the control group, 85.7% in the SFT group, and 60% in the PST group, but its impact declined over time. Additionally, SFT demonstrated potential for reducing healthcare costs compared to standard of care and PST. Further research is needed to provide nurses interventions for managing fatigue in IBD patients. The review protocol has been registered at OSF.io. [ABSTRACT FROM AUTHOR]

Background: Inflammatory bowel disease is a chronic inflammatory condition of the gut. It has two major subtypes Crohn's disease and ulcerative colitis. The follow-up consists of radiologic, molecular, endoscopic, and histological assessments. Intestinal ultrasound (IUS) is a noninvasive measure that provides future hope in guiding the management of IBD patients. This study is to assess the effectiveness of IUS in IBD patients' follow-up in our tertiary center during the pandemic. This is a prospective observational study during the COVID-19 pandemic. We used IUS to assess activity of IBD at baseline and at 6-month follow-up of patients on maintenance biological therapy using the following parameters: bowel haustrations, stratification, bowel wall thickness (BWT), Doppler sign (Limberg classification), presence of lymph nodes, or fibrofatty infiltration, echogenicity of the bowel, and presence of fistulae or abscesses. We compared the IUS with other radiologic parameters, histologic, and endoscopic scores at baseline before therapy, while we compared IUS with clinical scores and laboratory parameters before and after 24 weeks of biological treatment. Results: The cohort included 50 known IBD patients from June 2021 to January 2022. The laboratory studies showed a significant improvement in the hemoglobin indices, CRP, and fecal calprotectin from baseline and after 24 weeks. BWT, lumen diameter, lymph node presence, inflammatory signs, and Doppler activity signs were the most significant parameters in detecting improvement. However, there was no significant correlation between fecal calprotectin levels and ultrasound parameters. There was a positive correlation between MR and CT enterography, endoscopic parameters, and IUS parameters at baseline. Conclusions: IUS is an effective tool for follow-up of IBD patients especially during the pandemic periods. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to conduct a pre-conception care program for women of childbearing age with inflammatory bowel disease (IBD) in Korea and verify its effects on self-efficacy for IBD management, IBD-related pregnancy knowledge, and IBD-related pregnancy anxiety. It also aimed to explore the changes in participants through the program. Methods: A convergent mixed-methods study design was adopted. In the quantitative phase, 35 women (17 and 18 in the intervention and control group, respectively) participated. The intervention group attended a program that included small-group sessions and individual tele-coaching. To confirm the effects, data were collected before and one and four weeks after the intervention. In the qualitative stage, focus group interviews and tele-coaching were conducted with the intervention group. Results: After the program ended, significant differences were observed over time between the intervention and control groups for self-efficacy for IBD management (Wald χ² = 4.41, p = .036), IBD-related pregnancy knowledge (Wald χ² = 13.80, p < .001) and IBD-related pregnancy anxiety (Wald χ² = 8.61, p = .003). Qualitative data analysis revealed the following themes: (1) improving confidence in IBD management and awareness for planned pregnancy; (2) improving IBD awareness related to pregnancy and childbirth; and (3) relieving anxiety about and actively facing pregnancy. Conclusion: This study is meaningful in that, to the best of our knowledge, it is the first to develop a pre-conception care program for women diagnosed with IBD and confirm its effectiveness. Furthermore, this program is expected to be suitable for patient counseling and education in clinical practice. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) treatments in East Asian traditional medicine (EATM) originate from principles for treating abscesses and carbuncles. Understanding the therapeutic principles of Liu Juan Zi Gui Yi Fang (GYF) is essential for optimizing EATM treatment strategies for IBD, but quantitative analysis is lacking. This study aims to extract quantitative information on therapeutic strategies from GYF and present the EATM conceptual framework for IBD treatment. Oral prescriptions for carbuncles were selected, and their constituent herbs and indications were standardized and tokenized for analysis. An EATM expert group classified prescriptions based on the similarity of herbs and indications. Hierarchical and k-means cluster analyses were performed based on herb similarity. The herb–indication (H-I) network for all prescriptions was constructed. Additionally, H-I subnetworks based on the expert group's classifications and the k-means clustering results were constructed and compared to identify treatment goals and the herbs used for each goal. The results showed that the treatment focused on abscess status, wound healing, and patient's recovery capacity, with 'fever' and 'deficiency' as the main indications addressed by tonifying and anti-inflammatory herbs. The therapeutic principles identified in this study can serve as a foundation for developing future herbal intervention units. Further preclinical and clinical research is needed to validate these findings. [ABSTRACT FROM AUTHOR]

Background: Iran has been one of the most affected countries in the world by COVID-19. The aim of our study was to determine the outcome of COVID-19 in patients with inflammatory bowel disease (IBD). Furthermore, we analyzed the outcome of SARS-CoV-2 infection in patients with IBD treated with immunosuppressant. Materials and Methods: This is a cross-sectional, observational study. This study included all patients with IBD, regularly followed up in our IBD Clinic at a tertiary medical center from February 5th, 2020 to August 5th, 2022. We identified those patients with confirmed SARS-CoV-2 infection either by PCR test or chest computed tomography (CT) imaging. Results: A total of 401 patients were recruited (n=346 [86.28%] with ulcerative colitis, n=53 [13.22%] with Crohn’s disease, and 2 [0.5%] with indeterminate colitis). Of these patients, 273 (68.08%) developed no symptoms or signs during the follow-up period,128 patients developed symptoms similar to COVID-19, and 76 (18.9%) were diagnosed as confirmed COVID-19 cases. Men comprised 60.5% of the confirmed COVID-19 groups, which shows that men were statistically more likely to have symptoms of COVID-19 during the follow-up period (P=0.04). No significant differences were observed among confirmed and non-COVID-19 cases in terms of concomitant medications: steroids (P=0.6), thiopurines (P=0.23), anti-TNF (P=0.23), and aminosalicylate (P=0.61). Three patients required hospitalization, but there were no admissions to the intensive care unit or deaths related to COVID-19. Conclusion: The risk of COVID-19-related adverse outcomes and death in patients with IBD is low. Also, patients with IBD under immunosuppressive treatment are not at an increased risk of COVID-19. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This review aims to analyze the effectiveness of motivational interviewing (MI) in enhancing therapeutic adherence and compliance in adult patients with inflammatory bowel disease (IBD), especially considering the disruptions caused by the COVID-19 pandemic. Background: IBD, which includes conditions such as ulcerative colitis and Crohn's disease, affects over 10 million people globally. It significantly impacts both physical and psychological well-being, leading to challenges in therapeutic adherence. Only 25–47% of patients with IBD adequately follow prescribed treatments. Design and Methods: An integrative methodology that combines qualitative and quantitative research was utilized, following a 7-step framework. This framework encompasses identifying the research question, devising a search strategy, performing a critical appraisal, summarizing findings, extracting data, conducting an analysis, and drawing conclusions. Results: Poor adherence to therapy among patients with IBD can exacerbate disease progression and result in complications. MI has been identified as a promising approach to improving both adherence and treatment outcomes. Studies, including those predating the COVID-19 pandemic, have demonstrated MI's effectiveness in enhancing adherence among patients with IBD. Conclusions: MI shows promise in enhancing adherence among adult patients with IBD. Although initial results are promising, additional research is needed to thoroughly understand its effectiveness across various clinical contexts. Relevance to Clinical Practice: The findings underscore the potential of MI as an integral component of IBD treatment strategies, suggesting that its implementation could enhance patient–provider interactions and lead to better overall health outcomes. [ABSTRACT FROM AUTHOR]

This study introduces newly discovered chrysin derivatives that show potential as candidate molecules for treating inflammatory bowel disease (IBD). Compound 4b, among the synthesized compounds, displayed significant inhibitory effects on monocyte adhesion to colon epithelium induced by TNF-α, with an IC50 value of 4.71 μM. Furthermechanistic studies demonstrated that 4b inhibits the production of reactive oxygen species (ROS) and downregulates the expression of ICAM-1 and MCP-1, key molecules involved in monocyte-epithelial adhesion, as well as the transcriptional activity of NF-κB. In vivo experiments have shown that compound 4b exhibits a dose-dependent inhibition of 2, 4, 6-trinitrobenzenesulfonic acid (TNBS)- induced colitis in rats, thereby validating its effectiveness as a colitis inhibitor in animal models. These results indicate that 4b shows considerable promise as a therapeutic agent for managing IBD. [ABSTRACT FROM AUTHOR]

The article discusses various surgical interventions and their outcomes in urological treatments, focusing on pediatric and adult cases. Topics discussed include the use of sacral neuromodulation for pediatric bladder and bowel dysfunction, outcomes of continent catheterizing channels in high-risk patients, and comparisons between different surgical approaches for vesicoureteral reflux and post-prostatectomy urinary incontinence.

The enteric nervous system (ENS), consisting of neurons and glial cells, is situated along the gastrointestinal (GI) tract's wall and plays a crucial role in coordinating digestive processes. Recent research suggests that the optimal functioning of the GI system relies on intricate connections between the ENS, the intestinal epithelium, the immune system, the intestinal microbiome, and the central nervous system (CNS). Inflammatory bowel disease (IBD) encompasses a group of chronic inflammatory disorders, such as Crohn's disease (CD) and ulcerative colitis (UC), characterized by recurring inflammation and damage to the GI tract. This review explores emerging research in the dynamic field of IBD and sheds light on the potential role of ENS alterations in both the etiology and management of IBD. Specifically, we delve into IBD-induced enteric glial cell (EGC) activation and its implications for persistent enteric gliosis, elucidating how this activation disrupts GI function through alterations in the gut–brain axis (GBA). Additionally, we examine IBD-associated ENS alterations, focusing on EGC senescence and the acquisition of the senescence-associated secretory phenotype (SASP). We highlight the pivotal role of these changes in persistent GI inflammation and the recurrence of IBD. Finally, we discuss potential therapeutic interventions involving senotherapeutic agents, providing insights into potential avenues for managing IBD by targeting ENS-related mechanisms. This approach might represent a potential alternative to managing IBD and advance treatment of this multifaceted disease. [ABSTRACT FROM AUTHOR]

Background: The research on posttraumatic growth (PTG) promotion programmes, particularly narrative therapy (NT), for patients with inflammatory bowel disease (IBD) remains limited. This pilot study aims to develop an NT programme to promote PTG and evaluate its feasibility, preliminary effectiveness, participants' experiences and improvement suggestions. Methods: The NT programme was initially developed through literature review, interviews with IBD patients and expert panel discussions. A randomized controlled pilot trial was conducted to assess the feasibility and preliminary effectiveness of the programme. Participants in the NT group received five consecutive weekly sessions of the programme, while the control group received standard care. Outcomes including PTG, anxiety, depression and quality of life were measured. Qualitative interviews were conducted to explore participants' experiences and suggestions for programme modifications. Results: The NT programme was developed with scientific rigour. The recruitment rate and retention rate were 62.5% and 96.7%, respectively. A significant reduction in anxiety levels was observed, and manifestations of PTG were reported in the NT group. Suggestions for improvement of the NT programme were received from the participants. Conclusion: The NT programme was constructed to promote PTG in IBD patients in this study, further offering preliminary evidence for its feasibility and potential positive psychological change. However, large‐scale research is needed to validate its effectiveness for broader applications. [ABSTRACT FROM AUTHOR]

A study published in the journal Intestinal Research examined the use of fecal microbiota transplantation (FMT) for patients with inflammatory bowel disease (IBD) and recurrent Clostridioides difficile infection (CDI). The study found that FMT was effective in preventing CDI recurrence in IBD patients, but did not have a beneficial effect on the course of IBD itself. The study suggests that earlier use of FMT for CDI and early IBD therapy escalation may be beneficial in preventing IBD flare and colectomy. Further research is needed to fully understand the potential of FMT as a treatment option for IBD. [Extracted from the article]

Objective: This study aimed to explore the effect of ward-noise-reduction management on the mental health and quality of life of patients with inflammatory bowel disease. Methods: The medical records of 275 patients with inflammatory bowel disease admitted to the First Affiliated Hospital of Wenzhou Medical University from January 2020 to January 2023 were retrospectively analyzed. Routine care was performed for such hospitalized patients from January 2020 to July 2021. Thus, 124 patients were enrolled in the control group. From August 2021 to January 2023, our hospital implemented ward-noise-reduction management for such inpatients, and 151 patients were included in the observation group. The Athens Insomnia Scale (AIS), the State-Trait Anxiety Inventory, the Inflammatory Bowel Disease Questionnaire (IBDQ), and the noise level at the time of admission and discharge were compared. Results: No significant difference in the State Anxiety Scale (S-AI), Trait Anxiety Scale (T-AI), and AIS and IBDQ scores at baseline existed between the two groups (P >0.05). After nursing, the S-AI, T-AI, and AIS scores of the observation group were lower than those of the control group, and the IBDQ score of the observation group was higher than that of the control group (P < 0.05). The noise level of the observation group was lower than that of the control group during hospitalization in maximum sound level and average intermediate (P < 0.05). Conclusions: The application of ward-noise-reduction management in the nursing of patients with inflammatory bowel disease can improve their negative mood, improve their sleep quality, and quality of life, and reduce the ward noise level in maximum sound level and average intermediate, which has high clinical value. [ABSTRACT FROM AUTHOR]

Inflammatory bowel diseases are chronic and progressive inflammatory diseases of the gastrointestinal tract. Patients suffering from these diseases, especially if the standard treatment does not bring satisfactory results, more and more often turn to unconventional methods (complementary and alternative medicine). These methods are not only ineffective but also unsafe for the patient. For many of them, there is not enough scientific research. For this reason, the planning of such a method of therapy by the patient should be consulted with his or her doctor. The physician should discuss the potential benefits and risks of non-standard treatment with the patient and advise the patient not to stop conventional therapy. [ABSTRACT FROM AUTHOR]

A key challenge for the effective treatment of intestinal diseases, including inflammatory bowel disease (IBD), is to develop an oral drug delivery system that can resist gastric acid erosion and efficiently release drugs after rapid entry into the intestine. In the present work, we developed oral composite nanoparticles (MSZ@PRHS) consisting of a rough mesoporous silica (RHS) loaded with Mesalazine (MSZ) and a CAP polymer membrane for targeted relief of inflammation in colitis. At the pH values of the simulated stomach and small intestine, the release rate of MSZ from MSZ@PRHS was low, while at the pH values of the simulated colon, the release rate of MSZ was high. In dextran sulfate sodium salt (DSS)-induced acute colitis mouse model, compared with oral administration of the drug Mesalazine in the equivalent solution form, oral administration of PRHS loaded with drug-loaded nanoparticles can significantly alleviate the symptoms of inflammatory bowel disease, and improve the therapeutic effect. We propose that the intestinal microenvironment provides an interface for nanocomposites switch and a promising drug delivery platform for the management and treatment of many intestinal diseases, where controlled drug release and prolonged residence time are required. [ABSTRACT FROM AUTHOR]

Objective: Annexin A1(AnxA1) is an anti-inflammatory mediator. In the current study,we aimed to evaluate whether or not serum Annexin A1 levels of inflammatory boweldiseases (IBDs) patients relate to the clinical and laboratory traits of IBDs. Materials and Methods: This case-control study included 67 ulcerative colitis (UC) patients, 53 Crohn's disease (CD) patients and 60 healthy controls. The Mayo Clinical scoring system (MCS) was used for UC and the histological activity index (HAI) was determined by Truelove and Richards method. The Crohn's disease activity index (CDAI) was used for CD patients. Montreal classification was used for the localization of IBDs. Results: The mean serum AnxA1 concentrations were not statistically significant in UC, CD and the control groups (26.36±17.30 ng/ml vs 22.98±12.74 vs 24.45±12.18 ng/ml respectively, p=0.404). The MCS, HAI of UC patients negatively correlated with the serum AnxA1 values (rho=-0.616, p<0.001 vs rho=-0.778, p<0.001 respectively). UC patients with limited disease had higher values than those with extensive disease (19.5 (IQR:14.5-47.8) ng/ml vs.13.4 (IQR:10.8-18.4) ng/ml respectively, p=0.002). In CD patients, CDAI values negatively correlated to the serum AnxA1 values (rho=-0.770, p<0.001). Conclusions: Serum AnxA1 values might be an auxiliary biomarker for the disease activity in patients with IBDs. [ABSTRACT FROM AUTHOR]

Current evidence posits a central role for gut microbiota and the metabolome in the pathogenesis and progression of inflammatory bowel disease (IBD). Fecal microbiota transplantation (FMT) has been established as a means to manipulate this microbiome safely and sustainably. Several aspects of the technical improvement including pretreatment with antibiotics, use of frozen stool samples as well as short donortorecipient time are proposed to improve its response rates. Its efficacy in ulcerative colitis has been proven in clinical trials while data is emerging for Crohn's disease. This review describes briefly the biology behind FMT, the available evidence for its use in IBD, and the host, recipient and procedural factors which determine the clinical outcomes. [ABSTRACT FROM AUTHOR]

Inflammatory bowel diseases comprising Crohn's disease and ulcerative colitis have emerged as global diseases. Multiple distinct therapeutic mechanisms have allowed us to increase our rates of achieving remission and reducing permanent diseaserelated morbidity. However, there is limited data to inform relative positioning of different therapies. This review will summarize existing literature on use of clinical decision models to inform relative efficacy of one therapeutic mechanism compared to the other given individual patient characteristics. It will also demonstrate the value of serologic, transcriptomic (from biopsies), and microbiome-based biomarkers in identifying which therapy is most likely to work for a given patient. We will review the existing gaps in the literature in this field and suggest a path forward for future studies to better inform patient care, incorporating the principles of precision medicine in the management of inflammatory bowel disease. [ABSTRACT FROM AUTHOR]

Background: Inflammatory bowel disease (IBD) therapies now utilise higher doses of immunomodulatory and biologic therapies, predisposing patients to an increased risk of infections. Aims: We aimed to determine whether infections were associated with high anti‐tumour necrosis factor (TNF) drug levels in IBD and to quantify the risk and consequences of infections. Methods: Two retrospective studies were performed, a descriptive cohort study and a matched case–control study. For the matched case–control study, cases of infection occurring on anti‐TNF agents were matched in a 1:2 ratio to controls of anti‐TNF treated patients without infections. Results: In the descriptive study, 76 infections occurred in 60 patients, including 49 bacterial, 24 viral, four fungal and four parasitic. Of these, 61 (80.3%) were on biologics, 49 (64.5%) on immunomodulators and 11 (14.5%) on corticosteroids. Thirty‐four (44.7%) were on combination therapy, 27 (35.5%) on biologic monotherapy and 15 (19.7%) on immunomodulator monotherapy. Median anti‐TNF drug levels in infection cases were 3.9 μg/mL for infliximab and 6.0 μg/mL for adalimumab. In the case–control study, 32 cases of infection in 27 anti‐TNF treated patients were matched with 64 anti‐TNF treated controls without infections. Among infection cases, 59.5% were on combination therapy versus 40.6% on biologic monotherapy (P = 0.59). Median drug levels for cases and controls respectively were 3.9 μg/mL versus 5.5 μg/mL for infliximab (P = 0.72) and 6.0 μg/mL versus 9.9 μg/mL for adalimumab (P = 0.34). Conclusion: Infections in patients with IBD were common, and the risk was highest with combination therapy. Infections were not associated with high serum anti‐TNF levels. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) is a systemic disorder affecting intestinal tract and other organs outside the gut, known as extraintestinal manifestations (EIMs). These EIMs are complex and diverse, and early treatment may reduce teratogenic rates and improve quality of life. However, our understanding of EIMs in IBD is currently limited by a lack of mechanistic insight. Fortunately, advances in our understanding of intestinal microecology are allowing us to uncover the underlying mechanisms of EIMs. The gut microbiota can drive aberrant immune activation and intestinal inflammation. Intriguingly, chronic inflammation can also shape the microbiome in reverse and aggravate dysbiosis. Recent research has revealed that microbiome-derived signal molecules play a crucial role in catalyzing enterocolitis and altering mucosal barrier function. Furthermore, gut microbiota-associated antigens can translocate from the intestine to extraintestinal sites, leading to systemic inflammatory responses. The microbiome is showing its potential in treating IBD and EIMs, and microbial engineering approaches, such as probiotic engineering and engineered fecal microbiota transplantation, are exhibiting great promise for IBD therapeutics. [ABSTRACT FROM AUTHOR]

Objectives: Angiogenesis plays a significant role in the occurrence and development of inflammatory bowel disease (IBD). The aim of this study is to explore potential angiogenesis related genes (ARGs) in IBD through bioinformatics analysis and in vivo experiments. Methods: GSE57945, GSE87466, and GSE36807 were obtained from the Gene Expression Omnibus database. GSE57945 was used as the training set, while GSE87466 and GSE36807 were used as the validation set. The key ARGs associated with IBD were identified using the least absolute shrinkage and selection operator (LASSO) and random forest methods. These identified ARGs were then utilized to construct a diagnostic model for IBD. The Single-Sample Genome Enrichment Analysis, Cibersort, and Xcell methods were used to evaluate the immune infiltration. Expression of amyloid beta precursor protein (APP) was verified in the IBD mouse model induced by dextran sulfate sodium using immunohistochemistry (IHC). Results: The receiver operating curve area of GSE57945 was 0.948. Two distinct clusters were identified using consensus clustering and non-negative matrix factorization clustering. Subsequent analyses revealed significant differences in immune levels and functional enrichment between the two clusters. The successful construction of the animal model for the IBD was evident by hematoxylin and eosin staining, while IHC results showed a high expression of APP in IBD and a low expression in normal tissues. Conclusion: Our findings provide new insights into the diagnosis of IBD by ARGs, and APP could be a potential novel biomarker for IBD and promising therapeutic targets. [ABSTRACT FROM AUTHOR]

The discovery of novel probiotic bacteria from free-ranging animals for the treatment of inflammatory bowel disease in domestic pets is a unique approach. The chloroform extraction of gastrointestinal (GI) tract material was used to inactivate vegetative cells and select for spore-forming bacteria. A bacterium identified as a novel Paenibacillus sp. strain via small ribosomal RNA (16S) gene sequencing was isolated from the GI tract of a gray wolf (Canis lupus). The bacterium was typed as Gram-variable, both catalase/oxidase-positive and positive via starch hydrolysis and lipase assays. The bacterium inhibited the growth of Staphylococcus aureus, Escherichia coli and Micrococcus luteus. The draft whole genome sequence (WGS) assembly was 7,034,206 bp in length, encoding 6543 genes, and is similar in size and coding capacity to other closely related Paenibacillus spp. The isolate's genome encodes several germination and sporulation gene products along with antimicrobials such as a bacteriocin system and chitinase. Enzyme genes such as alpha amylase, cellulase, lipases and pectin lyase are also present in the genome. An incomplete lysogenic bacteriophage genome was also present in the isolate's genome. Phenotypic characteristics combined with a WGS genotype analysis indicate that this bacterium, designated Paenibacillus sp. ClWae2A, could be a potential candidate probiotic for domestic dogs. [ABSTRACT FROM AUTHOR]

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Background: Electronic patient-reported outcome (ePRO) systems are increasingly used in clinical trials to provide evidence of efficacy and tolerability of treatment from the patient perspective. The aim of this study is twofold: (1) to describe how we developed an electronic platform for patients to report their symptoms, and (2) to develop and undertake usability testing of an ePRO solution for use in a study of cell therapy seeking to provide early evidence of efficacy and tolerability of treatment and test the feasibility of the system for use in later phase studies. Methods: An ePRO system was designed to be used in a single arm, multi-centre, phase II basket trial investigating the safety and activity of the use of ORBCEL-C™ in the treatment of patients with inflammatory conditions. ORBCEL-C™ is an enriched Mesenchymal Stromal Cells product isolated from human umbilical cord tissue using CD362+ cell selection. Usability testing sessions were conducted using cognitive interviews and the 'Think Aloud' method with patient advisory group members and Research Nurses to assess the usability of the system. Results: Nine patient partners and seven research nurses took part in one usability testing session. Measures of fatigue and health-related quality of life, the PRO-CTCAE™ and FACT-GP5 global tolerability question were included in the ePRO system. Alert notifications to the clinical team were triggered by PRO-CTCAE™ and FACT-GP5 scores. Patient participants liked the simplicity and responsiveness of the patient-facing app. Two patients were unable to complete the testing session, due to technical issues. Research Nurses suggested minor modifications to improve functionality and the layout of the clinician dashboard and the training materials. Conclusion: By testing the effectiveness, efficiency, and satisfaction of our novel ePRO system (PROmicsR), we learnt that most people with an inflammatory condition found it easy to report their symptoms using an app on their own device. Their experiences using the PROmicsR ePRO system within a trial environment will be further explored in our upcoming feasibility testing. Research nurses were also positive and found the clinical dashboard easy-to-use. Using ePROs in early phase trials is important in order to provide evidence of therapeutic responses and tolerability, increase the evidence based, and inform methodology development. Trial registration: ISRCTN, ISRCTN80103507. Registered 01 April 2022, https://www.isrctn.com/ISRCTN80103507 Plain English summary: More and more patients tell clinicians how they feel by completing questionnaires electronically. Therefore, it is important to assess how easy it is for patients to do this. In this study, we describe how we developed an electronic platform for patients to report their symptoms and how we tested the usability of this platform with patient partners and research nurses. Once the electronic platform was developed, quality of life and symptoms questionnaires were programmed onto it. Alerts were sent to the clinical team if specific scores were obtained on the symptoms questionnaires. Although two patient partners were not able to finish the testing session because of technical issues, the ones who completed the session liked its simplicity and responsiveness. The research nurses also liked the system and only suggested minor modifications. Following this testing, we refined the electronic platform to test it further in a larger study which investigates the safety and use of a drug. We hope that thanks to this electronic platform, we will obtain useful information on the safety and efficacy of treatment. [ABSTRACT FROM AUTHOR]

Background/Aims: The frequency and details of nonalcoholic fatty liver disease (NAFLD) complications in patients with inflammatory bowel disease (IBD) remain unclear. This study aimed to clarify characteristics of NAFLD in patients with IBD. Methods: We retrospectively identified and enrolled patients with IBD diagnosed with or without NAFLD by undergoing abdominal computed tomography (CT) at our institution between 2005 and 2020. The primary endpoint was the complication rate of NAFLD in patients with IBD. Secondary endpoints were the clinical characteristics of nonobese patients with IBD and comorbid NAFLD and their association with nutritional and inflammatory parameters. Results: Twenty-one (21.9%) of 96 eligible patients with IBD also had NAFLD. In nonobese patients (defined as patients with a body mass index < 25 kg/m²), C-reactive protein (CRP; P< 0.001) and alanine aminotransferase (P= 0.018) levels were higher and the albumin level (P= 0.005) and prognostic nutritional index (PNI; P= 0.002) values were lower in patients with NAFLD than in those without NAFLD. The PNI value was positively correlated (P< 0.001) and the CRP level was negatively correlated (P= 0.001) with the hepatosplenic ratio. However, in the NAFLD combined group, PNI (P< 0.05) and CRP values (P< 0.001) were improved over time after CT imaging by continuing IBD treatment. Conclusions: Worsening nutritional and inflammatory status in IBD patients is associated with complications of NAFLD. Diagnosis of NAFLD in IBD patients using CT imaging might be useful not only for early detection of NAFLD but also in assessing the need for therapeutic intervention for IBD. [ABSTRACT FROM AUTHOR]

Background/Aims: Evidence on predictors of primary nonresponse (PNR), and secondary loss of response (SLR) to anti-tumor necrosis factor (anti-TNF) agents in inflammatory bowel disease is scarce from Asia. We evaluated clinical/biochemical/molecular markers of PNR/SLR in ulcerative colitis (UC) and Crohn's disease (CD). Methods: Inflammatory bowel disease patients treated with anti-TNF agents (January 2005-October 2020) were ambispectively included. Data concerning clinical and biochemical predictors was retrieved from a prospectively maintained database. Immunohistochemistry for expression of oncostatin M (OSM), OSM receptor (OSM-R), and interleukin-7 receptor (IL-7R) were done on pre anti-TNF initiation mucosal biopsies. Results: One-hundred eighty-six patients (118 CD, 68 UC: mean age, 34.1 ± 13.7 years; median disease duration at anti-TNF initiation, 60 months; interquartile range, 28-100.5 months) were included. PNR was seen in 17% and 26.5% and SLR in 47% and 28% CD and UC patients, respectively. In CD, predictors of PNR were low albumin (P< 0.001), postoperative recurrence (P= 0.001) and high IL-7R expression (P< 0.027) on univariate; and low albumin alone (hazard ratio [HR], 0.09; 95% confidence interval [CI], 0.03-0.28; P< 0.001) on multivariate analysis respectively. Low albumin (HR, 0.31; 95% CI, 0.15-0.62; P= 0.001) also predicted SLR. In UC, predictors of PNR were low albumin (P< 0.001), and high C-reactive protein (P< 0.001), OSM (P< 0.04) and OSM-R (P= 0.07) stromal expression on univariate; and low albumin alone (HR, 0.11; 95% CI, 0.03-0.39; P= 0.001) on multivariate analysis respectively. Conclusions: Low serum albumin at baseline significantly predicted PNR in UC and PNR/SLR in CD patients. Mucosal markers of PNR were high stromal OSM/OSM-R in UC and high IL-7R in CD patients. [ABSTRACT FROM AUTHOR]

Primary sclerosing cholangitis (PSC) is a progressive cholestatic, inflammatory, and fibrotic disease that is strongly associated with inflammatory bowel disease (IBD). PSC-IBD represents a unique disease entity and patients with this disease have an increased risk of malignancy development, such as colorectal cancer and cholangiocarcinoma. The pathogenesis of PSC-IBD involves genetic and environmental factors such as gut dysbiosis and bile acids alteration. However, despite the advancement of disease characteristics, no effective medical therapy has proven to have a significant impact on the prognosis of PSC. The treatment options for patients with PSC-IBD do not differ from those for patients with PSC alone. Potential candidate drugs have been developed based on the pathogenesis of PSC-IBD, such as those that target modulation of bile acids, inflammation, fibrosis, and gut dysbiosis. In this review, we summarize the current medical treatments for PSC-IBD and the status of new emerging therapeutic agents. [ABSTRACT FROM AUTHOR]

Pediatric inflammatory bowel disease (IBD) is a chronic, life-threatening gastrointestinal tract disease that usually involves the terminal ileum, cecum, colon, and perianal area. There has been a growing incidence of IBD reported worldwide, and it is becoming an increasing concern for pediatric health care. This discussion covers the global significance, the subtypes, diagnostic criteria, and advances in pediatric IBD management. [ABSTRACT FROM AUTHOR]

As the prevalence of older adults with inflammatory bowel disease (IBD) is rising, understanding the unique challenges in both diagnosis and management is becoming increasingly important. Knowledge of phenotypic differences as well as overlapping symptoms with other medical conditions is critical to obtaining a timely diagnosis of IBD in older adults. Although older adults with IBD are at higher risk for adverse events compared with younger adults with IBD, recent data have suggested that ongoing disease activity may be a significant driver of adverse clinical outcomes rather than use of current treatment modalities. Ultimately, earlier and effective treatments can improve outcomes and quality of life for older adults with IBD. However, to help improve medical decision-making, clinicians must move away from the use of chronological age alone and begin to integrate measures of biological age, such as frailty and sarcopenia, into risk stratification tools. This article reviews the management considerations for older adults with IBD and provides the rationale for incorporating measures of biological age into current practice. [ABSTRACT FROM AUTHOR]

Introduction: Patients with inflammatory bowel disease (IBD) on biologic therapies are at increased risk of infections, emphasizing the importance of immunization. This study aimed to assess vaccination prevalence among patients with IBD on specific biologic therapies. Methods: A surveybased cross-sectional study was conducted at an IBD center, including patients receiving different biologic therapies from 1 January 2022 to the 30 April 2023. Demographic and vaccination data were collected using patient electronic records and patient interviews. Results: A total 394 patients (100%) received the measles, mumps, rubella (MMR), tetanus, reduced diphtheria, and acellular pertussis (Tdap) vaccine. A total of 79 patients (20%) received the influenza vaccine, 40 patients (10.2%) were vaccinated against hepatitis A (HAV), and 34 patients (8.6%) received the pneumococcal vaccine. From the 103 female patients who are eligible to take human papillomavirus (HPV) vaccine, only 7 (6.8%) received it. Out of the 100 eligible patients above the age of 50, only 9 (9%) received the herpes zoster (HZ) vaccine. Conclusion: The uptake of certain vaccines such as Hepatitis B (HBV), seasonal influenza, HAV, pneumococcal, HZ and HPV vaccines among patients with IBD were below expectations. These findings highlight the need for interventions to improve patients' awareness and adherence to prevent infectious complications in patients with IBD. [ABSTRACT FROM AUTHOR]

Background: It is unknown if the clinical manifestations and phenotype of disease are comparable between early- and elderlyonset inflammatory bowel disease (IBD). We aimed to seek differences in disease phenotype, course, complications, and treatment between early- and elderly-onset IBD patients. Methods: This retrospective cohort study on registered IBD patients in the Iranian Registry of Crohn's and Colitis (IRCC) compared demographics, disease phenotype, disease activity, IBD-related surgery and medications between early- and elderly-onset IBD. A generalized linear regression model was used to investigate the relative risk of age at diagnosis adjusted for gender and disease duration for the outcomes. Results: From 10 048 IBD patients, 749 with early-onset (7.5%), and 472 (4.7%) elderly-onset IBD were enrolled: 855 (63.1%) ulcerative colitis (UC) and 366 (26.9%) Crohn's disease (CD). Left-sided colitis was more frequent among elderly-onset UC patients (P < 0.001). Ileum and ileocolonic locations were the most common types in elderly-onset and early-onset CD patients, respectively. In comparison with elderly-onset UC, early-onset cases more often used prednisolone (22.1% vs. 11.4%, P = 0.001), immunomodulators (44.9% vs 25.2%, P < 0.001) and anti-tumor necrosis factors (TNF) (20.1% vs 11.9%, P = 0.002). Elderly-onset UC patients had 0.7 times lower risk of aggressive phenotype (95%CI:0.6-0.9, P = 0.005). Early-onset CD was associated with higher use of prednisolone (27.7% vs 8.1%, P < 0.001), immunomodulators (58.7% vs 41.8%, P = 0.005) and anti-TNF (49.6% vs 35.4%, P = 0.006). Conclusion: Early-onset IBD was associated with a more aggressive phenotype and higher prednisolone, immunomodulators, and anti-TNF use. [ABSTRACT FROM AUTHOR]

Gastroenterology nurses are acutely aware of gaps in health care and research experienced by people with inflammatory bowel disease (IBD) and the clinicians delivering care. The Australian Government's IBD National Action Plan 2019 (NAP) recognised the variability in care and services for people with IBD and recommended using more effective interventions for chronic disease management. Addressing priority actions of the NAP, Crohn's & Colitis Australia (CCA) are implementing projects to improve health literacy for people with IBD and awarenessand education to supportgeneral practitioners (GPs) to participate in IBD care. In addition, a national project identifyingthe priorities of research for people with IBD and the health professionals that deliver their care has been completed. New codesigned consumer resources to improve health literacy of people living with IBD and carers have been developed. Resources are in a variety of formats including website and social media information, animated videos and print materials tailored for priority populations includingyoung people, people living in rural and remote regions, and people with diverse cultural backgrounds. Sixonlineeducational learning modules and associated workshops and podcasts were developed by an expert commidee to provide a comprehensive professional development resource for GPs and physicians about managing IBD. The top 10 research priorities for IBD were identified by people with IBD in Australia, carers and IBD clinicians around thetopics of prevention, symptoms, treatmentand livingwith IBD. Nurses have an opportunity to engage with these evidence-based resources to improve consumer health literacy of IBD, healthcare professional knowledge of managing IBDand future direction of IBD research. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) frequently affects women of childbearing age and often coincides with pregnancy. With an increased incidence of IBD, gastroenterologists and obstetricians are more frequently involved in caring for women of reproductive age. While the development of novel therapies has allowed for successful conception and pregnancy outcomes, many patients may hesitate to conceive due to concerns for presumed adverse IBD effects on maternal and fetal health. As such, a noticeable percentage of patients may choose voluntary childlessness. Indeed, active IBD carries a greater risk of adverse pregnancy outcomes, including a loss of pregnancy, preterm delivery, and emergent C-sections. However, those with a quiescent disease tend to have fewer pregnancy complications. Therefore, it is essential to achieve remission prior to conception to optimize pregnancy outcomes. Dedicated IBD and pregnancy clinics can greatly assist in improving patient knowledge and attitudes towards pregnancy; through individualized pre-conception counseling, education, and medication adherence, the risks of poor pregnancy outcomes can be minimized. Furthermore, it is important for healthcare providers to have a sufficient understanding of the medication safety and tools to measure the disease activity, while counseling patients during gestation and breastfeeding periods. This review article aims to provide the most recent evidence-based management methods for IBD during pregnancy. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) is an umbrella term for two chronic and recurrent digestive conditions, Crohn's disease (CD) and ulcerative colitis (UC). Both are characterized by chronic inflammation of the gastrointestinal tract but not caused by infection or other identifiable causes. Childhood IBD often leads to a more extensive disease and a more aggressive course than adult-onset disease. Since children spend a lot of time at school, children with IBD may experience symptoms while at school. As a result, school nurses play a crucial role in identifying and managing students with IBD within their school or school district. It is important for a school nurse to understand the etiology, symptoms, and management of IBD to provide management of care at school. [ABSTRACT FROM AUTHOR]

Simple Summary: Although the incidence of inflammatory bowel disease (IBD)-related cancer has been decreasing, its prognosis remains worse than that of non-IBD-related cancers, owing to its multiple risk factors. This review explores the risk factors, epidemiology, surveillance strategies, and treatment recommendations for IBD-related cancers, as well as potential future research directions. Patients with inflammatory bowel diseases (IBDs), such as ulcerative colitis and Crohn's disease, have an increased risk of developing colorectal cancer (CRC). Although advancements in endoscopic imaging techniques, integrated surveillance programs, and improved medical therapies have contributed to a decreased incidence of CRC in patients with IBD, the rate of CRC remains higher in patients with IBD than in individuals without chronic colitis. Patients with IBD-related CRCs exhibit a poorer prognosis than those with sporadic CRCs, owing to their aggressive histological characteristics and lower curative resection rate. In this review, we present an updated overview of the epidemiology, etiology, risk factors, surveillance strategies, treatment recommendations, and prognosis of IBD-related CRCs. [ABSTRACT FROM AUTHOR]

Diet is an important determinant of health and consequently is often implicated in the development of disease, particularly gastrointestinal (GI) diseases, given the high prevalence of meal-related symptoms. The mechanisms underlying diet-driven pathophysiology are not well understood, but recent studies suggest that gut microbiota may mediate the effect of diet on GI physiology. In this review, we focus primarily on two distinct GI diseases where the role of diet has been best studied: irritable bowel syndrome and inflammatory bowel disease. We discuss how the concurrent and sequential utilization of dietary nutrients by the host and gut microbiota determines the eventual bioactive metabolite profiles in the gut and the biological effect of these metabolites on GI physiology. We highlight several concepts that can be gleaned from these findings, such as how distinct effects of an individual metabolite can influence diverse GI diseases, the effect of similar dietary interventions on multiple disease states, and the need for extensive phenotyping and data collection to help make personalized diet recommendations. [ABSTRACT FROM AUTHOR]

Clinical trials have led to major advances in inflammatory bowel disease (IBD) care over the last few decades, yet in that time most clinical trial protocols in IBD have remained markedly the same. Many IBD protocols often still require face-to-face visits and monitoring, hospital-based medication administration, paper-based forms and questionnaires, and short follow-up periods resulting in limited long-term data. These factors have recently been recognized as likely contributors to the low recruitment and lack of diversity of participants across clinical trials in IBD. However, with increasing technological advances, there is now an opportunity for improvement. This article assesses a range of virtual innovations for how they may offer digital solutions to challenges currently encountered in IBD clinical trials. Such solutions include consideration for increasing patient diversity, digital invitation, remote consent and recruitment, virtual visits, remote patient monitoring and data collection, remote medication delivery and administration, remote clinical trial monitoring, and routinely collected health data for long-term follow-up. Adoption of virtual technology may drive the field toward patient centricity and more efficient trial protocols to allow for a new era in IBD clinical trials. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD), comprising Crohn’s disease and ulcerative colitis, is a lifelong disease that manifests with chronic intestinal inflammation, sequential fibrosis, and an increased risk of colitis-associated colon cancer (CAC). The combined effects of genetic, immunological, environmental, and microbial factors render it difficult to determine the specific mechanism underlying the induction and perpetuation of IBD. Various animal models of IBD have contributed enormously to the understanding of IBD pathogenesis in terms of genomics, transcriptomics, proteomics, microbiome, and drug development of novel therapeutics. Although comprehensive research on IBD has been enabled by advanced technologies, such as genetically engineered models, there is a great need to develop relevant in vivo models of colitis and fibrosis. Here, we review 4 categories of animal models of acute and chronic intestinal inflammation, fibrosis, and CAC: chemically induced, genetically engineered, T cell transfer, and spontaneous gene mutation models. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease encompasses Crohn’s disease and ulcerative colitis and is characterized by uncontrolled, relapsing, and remitting course of inflammation in the gastrointestinal tract. Artificial intelligence represents a new era within the field of gastroenterology, and the amount of research surrounding artificial intelligence in patients with inflammatory bowel disease is on the rise. As clinical trial outcomes and treatment targets evolve in inflammatory bowel disease, artificial intelligence may prove as a valuable tool for providing accurate, consistent, and reproducible evaluations of endoscopic appearance and histologic activity, thereby optimizing the diagnosis process and identifying disease severity. Furthermore, as the applications of artificial intelligence for inflammatory bowel disease continue to expand, they may present an ideal opportunity for improving disease management by predicting treatment response to biologic therapies and for refining the standard of care by setting the basis for future treatment personalization and cost reduction. The purpose of this review is to provide an overview of the unmet needs in the management of inflammatory bowel disease in clinical practice and how artificial intelligence tools can address these gaps to transform patient care. [ABSTRACT FROM AUTHOR]

Background/Aims: As the characteristics of inflammatory bowel disease (IBD) differ between Asians and Westerners, it is necessary to determine adequate therapeutic strategy for Asian IBD patients. We evaluated the current treatment of IBD in Asian countries/regions using a web-based survey. Methods: The Korean Association for the Study of Intestinal Diseases conducted a multinational web-based survey for current IBD care in Asia between September 16, 2020, and November 13, 2020. Results: A total of 384 doctors treating IBD patients from 24 Asian countries/regions responded to the survey. Anti-tumor necrosis factor (TNF) agents, anti-integrins, and anti-interleukin-12/23 agents were available for use by 93.8%, 72.1%, and 70.1% of respondents in Asian countries/regions. Compared with a previous survey performed in 2014, an increased tendency for treatment with biologics, including anti-TNF agents, was observed. In the treatment of corticosteroid-refractory acute severe ulcerative colitis, 72.1% of respondents chose anti-TNF agents, followed by tacrolimus (11.7%). In the treatment of corticosteroid-refractory Crohn’s disease, 90.4% chose anti-TNF agents, followed by thiopurines (53.1%), anti-interleukin-12/23 agents (39.3%), and anti-integrin agents (35.7%). In the treatment of Crohn’s disease patients refractory to anti-TNF agents, the most preferred strategy was to measure serum levels of anti-TNF and anti-drug antibodies (40.9%), followed by empiric dose escalation or shortening of dosing intervals (25.3%). Conclusions: Although there were some differences, treatment strategies for patients with IBD were mostly similar among Asian doctors. Based on the therapeutic outcomes, it is necessary to identify the most appropriate therapeutic strategy for Asian IBD patients. [ABSTRACT FROM AUTHOR]

Background/Aims: Long-term immunosuppressive therapies used to treat inflammatory bowel disease (IBD) are associated with an increased risk of infections, many of which can be prevented by vaccination. We assessed physicians’ current approaches and clinical practices regarding vaccinations for IBD patients in different Asian countries/regions. Methods: An internetbased survey was conducted among members of the Asian Organization for Crohn’s and Colitis from September 2020 to November 2020. The questionnaire consisted of 2 parts covering general opinion on the relevance of vaccinations and clinical practice of vaccination. Results: Overall, 384 Asian medical doctors responded to the survey. The majority of respondents considered it very (57.6%) or sufficiently (39.6%) important to perform vaccinations as recommended by the guidelines. About half of the Asian physicians (52.6%) were usually or always performing vaccinations. The influenza vaccine was the most frequently recommended vaccine for IBD patients. Half of the respondents (51.3%) did not recommend hepatitis A vaccine, especially in China (61.6%) and Japan (93.6%). The diphtheria, tetanus, and pertussis vaccine were never (35.2%) or rarely (29.4%) recommended. Conclusions: The findings of this survey indicated similarities among countries/regions in terms of the current approaches and practices regarding vaccination of IBD patients; however, there are some differences that might reflect each country’s domestic vaccination guidelines and health insurance particularly with certain vaccines in some countries/regions. Although Asian physicians largely recommend vaccination, more awareness among doctors and Asian consensus regarding differences in IBD vaccination among countries/regions may be required. [ABSTRACT FROM AUTHOR]

Background/Aims: Inflammatory bowel disease (IBD) is no longer a rare disease in Asia, thus it needs to prepare recommendations relevant to Asian patients. This study aimed to identify disparities in the process of the diagnosis of IBD in Asian countries/regions. Methods: In line with the 2020 Asian Organization for Crohn’s and Colitis annual meeting, a multinational webbased survey about Asian physicians’ perspectives on IBD was conducted. Results: A total of 384 Asian physicians (99 in China, 93 in Japan, 110 in Korea, and 82 in other Asian countries/regions) treating IBD patients from 24 countries/regions responded to the survey. Most respondents were gastroenterologists working in an academic teaching hospital. About half of them had more than 10 years of clinical experience in caring for patients with IBD. The European Crohn’s Colitis Organisation guideline was used most commonly for the diagnosis of IBD except for Japanese physicians who preferred their own national guideline. The Mayo score and Crohn’s Disease Activity Index were the most commonly used activity scoring systems for ulcerative colitis and Crohn’s disease, respectively. Endoscopy, not surprisingly, was the main investigation in assessing the extent and activity of IBD. On the other hand, there were disparities across countries/regions with regard to the favored modalities of small bowel and perianal evaluation of Crohn’s disease, as well as the use of serologic markers. Conclusions: Results of the present survey revealed practical behaviors of Asian physicians in the diagnosis of IBD. Investigating the reasons for different diagnostic approaches among countries/regions might help us develop Asian guidelines further. [ABSTRACT FROM AUTHOR]

Background/Aims: Infectious complications are major concerns when treating patients with inflammatory bowel disease (IBD). This study evaluated clinical differences across countries/regions in the management of infectious diseases in patients with IBD. Methods: A multinational online questionnaire survey was administered to participants at the 8th meeting of the Asian Organization for Crohn’s and Colitis. The questionnaire included questions regarding surveillance, diagnosis, management, and prevention of infection in patients with IBD. Results: A total of 384 physicians responded to the questionnaire. The majority of Korean (n = 70, 63.6%) and Chinese (n = 51, 51.5%) physicians preferred vancomycin to metronidazole in the treatment of Clostridium difficile infection, whereas more than half of the Japanese physicians (n = 62, 66.7%) preferred metronidazole. Physicians in Korea (n = 88, 80.0%) and China (n = 46, 46.5%) preferred a 3-month course of isoniazid and rifampin to treat latent tuberculosis infection, whereas most physicians in Japan (n = 71, 76.3%) favored a 9-month course of isoniazid. Most Korean physicians (n = 89, 80.9%) recommended hepatitis B virus (HBV) vaccination in patients lacking HBV surface antigen, whereas more than half of Japanese physicians (n = 53, 57.0%) did not consider vaccination. Conclusions: Differences in the diagnosis, prevention, and management of infections in patients with IBD across countries/regions reflect different prevalence rates of infectious diseases. This survey may broaden understanding of the real-world clinical settings across Asian countries/regions and provide information for establishing practical guidelines to manage patients with IBD. [ABSTRACT FROM AUTHOR]

Background: As the population ages, the number of elderly inflammatory bowel disease (IBD) patients is expected to increase. The clinical features and therapeutic options for young and old patients may differ, as elderly IBD patients are likely to have different comorbidities and disease characteristics. The goal of this study was to examine the clinical aspects and therapeutic choices for elderly Saudi IBD patients. Methods: We conducted a retrospective study aimed at describing the demographic, clinical, and management characteristics of IBD in elderly patients (≥60 years) who followed up at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. The data was extracted from the KAUH inflammatory bowel disease information system (IBDIS) registry. The primary outcome was to describe disease characteristics in accordance with the Montréal classification and the secondary outcomes were to describe treatment patterns and identify significant clinical associations. Results: Our data were collected from 76 patients who fulfilled the study inclusion criteria. Females outnumbered males (53.9% vs 46.1%) and the mean age was 51.5 ± 9.7 years. Essential hypertension (26.3%) was the most common comorbidity followed by diabetes mellitus (23.6%), and malignant neoplasms (9.21%). More than half of the patients with Crohn's disease (CD) had disease onset after forty years of age. The most common form of disease distribution was ileocolonic disease (64.7%). Less than 17% of patients had a penetrating disease phenotype. About 88 percent of patients with UC presented >40 years of age. Approximately, half of the cohort had left-sided ulcerative colitis (UC) (48%), followed by pancolitis (40%). The most prescribed medication class for IBD was 5-aminosalicylic acid (5-ASA) derivatives (56.58%) followed by corticosteroids and immunosuppressive drugs. Conclusions: In Saudi Arabia, age-specific concerns including comorbidities and polypharmacy remain the major challenges in the management of elderly IBD patients. [ABSTRACT FROM AUTHOR]

Background • The Borrelia species is recognized to cause a myriad of non-specific symptoms among Lyme patients. It has also been documented in the literature to have the ability to incite autoimmune responses. Despite this, very few clinical cases have ever put together the autoimmune connection to such infections, including in Crohn’s disease. Case Presentation • A 14-year-old adolescent male with a previous diagnosis of Crohn’s disease was discovered to have underlying Lyme disease caused by Borrelia burgdorferi infection. Identifying this as a potential cause of his autoimmune condition, an integrative medical approach was initiated, resulting in successful treatment and complete remission. Conclusions • Lyme disease should be recognized as a potential trigger of autoimmune conditions, especially Crohn’s disease. This underlying cause is novel to the literature and may help many patients obtain the proper diagnosis so that curative treatment may be received. [ABSTRACT FROM AUTHOR]

Simple Summary: With the increase in life-expectancy and the aging population, patients with inflammatory bowel disease are being exposed to immunomodulating drugs for longer periods. This, as well as the already recognized higher risk of some cancers in these patients when compared to the general population, makes the challenge of managing a patient with inflammatory bowel disease and current or past cancer more common. As large prospective studies are awaited, we summarize the available data on cancer risk in inflammatory bowel disease patients, the risk of cancer recurrence with immunomodulating therapy, the effects of cancer treatment on inflammatory bowel disease, and current recommendations on how to balance the risks and benefits of different treatments in these patients. Inflammatory bowel disease (IBD) is a chronic disease for which medical treatment with immunomodulating drugs is increasingly used earlier to prevent disability. Additionally, cancer occurrence in IBD patients is increased for several reasons, either IBD-related or therapy-associated. Doctors are therefore facing the challenge of managing patients with IBD and a past or current malignancy and the need to balance the risk of cancer recurrence associated with immunosuppressive drugs with the potential worsening of IBD activity if they are withdrawn. This review aims to explore the features of different subtypes of cancer occurring in IBD patients to present current evidence on malignancy recurrence risk associated with IBD medical therapy along with the effects of cancer treatment in IBD and finally to discuss current recommendations on the management of these patients. Due to sparse data, a case-by-case multidisciplinary discussion is advised, including inputs from the gastroenterologist, oncologist, and patient. [ABSTRACT FROM AUTHOR]

Primary Sclerosing Cholangitis (PSC) is a chronic cholestatic liver disease which is associated with Inflammatory Bowel Disease (IBD) in 70% of cases. It seems PSC/IBD is a distinct phenotype that is different from PSC, and IBD alone. Hence, we review the epidemiology, pathogenesis, natural course and management of PSC/IBD before and after LT for PSC. Extensive colitis, rectal sparing, backwash ileitis, and mild symptoms are the characteristics of IBD coexisting with PSC. Moreover, PSC patients with concurrent IBD have higher risk of cholangiocarcinoma, and colorectal neoplasia predominantly in right colon and at younger age. Therefore, it is essential to monitor these individuals continuously. It is interesting to note that the course of IBD (ulcerative colitis) after liver transplantation (LT) for PSC varies greatly, and some patients may develop worsening colitis after LT despite immunosuppressive regimens. As well, management of these patients was discussed in this review. [ABSTRACT FROM AUTHOR]

The aim of this retrospective study was to investigate the prevalence of Helicobacter pylori (H. pylori) in patients with ulcerative colitis or Crohn's disease who received TNF-a blocker therapy compared to a control group and to evaluate H. pylori as a potential side effect of TNF-a inhibitors in patients with dyspeptic complaints. This study included 140 patients aged 20-85 years. Among these patients, 70 were diagnosed with ulcerative colitis or Crohn's disease and prescribed TNF-a blockers assigned to the study group. The remaining 70 patients did not receive TNF-a blockers and were assigned to the control group. Patients' demographic data such as age and gender, biochemical laboratory parameters, dyspeptic diseases, drugs used and duration of usage were recorded. The quantity of H. pylori positivity was found as 45.7% in all patients. Of the 76 male patients, 39 (51.3%) were H. pylori (+), and 37 (48.7%) were H. pylori (-). Of the 64 female patients, 25 (39.1%) were H. pylori (+), and 39 (60.9%) were H. pylori (-). There was no statistically prominent disparity between the H. pylori (+) and H. pylori (-) patients regarding age and gender. The rate of H. pylori positivity was statistically meaningly lower in the study group compared to the control group (p=0.027). Our study suggests that TNF-a blockers may increase the risk of H. pylori infection in patients with ulcerative colitis or Crohn's disease and that H. pylori should be considered a potential side effect of TNF-a inhibitor therapy in these patients. Further research is needed to confirm these findings and investigate this association's underlying mechanisms. Clinicians should consider testing for H. pylori in patients receiving TNF-a inhibitors who develop dyspeptic symptoms. [ABSTRACT FROM AUTHOR]

Background: For children with inflammatory bowel disease (IBD), understanding their condition may lead to better outcomes. Knowledge assessment is imperative to identify where education may be required. An IBD knowledge assessment tool (IBD-KID2) is available in English; the aim of this study was to translate IBD-KID2 in to Italian and assess its validity/reliability among children with IBD. Methods: IBD-KID2 has fifteen items, scoring one point per correct answer. IBD-KID2 items were assessed for cultural comprehension/relevance by Italian gastroenterologists using a content validity index; those items with a maximum score proportion <0.78 were reviewed. IBD-KID2 was then translated using 'forward–backward' process and reviewed for content/meaning. A prospective study among Italian children with IBD enabled score comparisons with established populations (z test), and reliability was assessed using test–retest completion (Pearson correlation (r), paired t-test). Results: Twenty-five children participated: 16 (64%) male, mean age 14.9 years (SD2.4), Crohn's disease 13 (52%). The mean IBD-KID2 score was 8.8 (SD2.8), with no association with independent variables. Test–retest showed strong correlation between scores (r = 0.78, p < 0.001), with no mean difference (p = 0.39). Comparison with other pediatric IBD populations (NZ/Australia/Canada) showed no score difference (p = 0.62, CI −0.9 to 1.5). Conclusions: The translation of IBD-KID2 to Italian used a rigorous methodology. Scores showed the translated tool has equivalence and generalizability to Italian children with IBD. [ABSTRACT FROM AUTHOR]