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Inflammatory Bowel Disease (IBD): Clinical Diagnosis and Treatment
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Inflammatory Bowel Disease (IBD): Clinical Diagnosis and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 20 December 2024 | Viewed by 3576

Special Issue Editors

Dr. Moisés Tolentino B. Da Silva

E-Mail Website
Guest Editor
Laboratory of Physiology, Department of Immuno-Physiology e Pharmacology, Institute of the Biomedical Science Abel Salazar, (ICBAS), School of Medicine and Biomedical Sciences, Center for Drug Discovery and Innovative Medicines (MedInUP), University of Porto, Porto, Portugal
Interests: gatrointestinal motility; intestinal bowel disease; physical exercise; intestinal inflammation; enteric nervous system
Special Issues, Collections and Topics in MDPI journals
Dr. Isabel Silva

E-Mail Website
Guest Editor
Laboratory of Pharmacology and Neurobiology, Department of Immuno-Physiology e Pharmacology, Institute of the Biomedical Science Abel Salazar, (ICBAS), School of Medicine and Biomedical Sciences, Center for Drug Discovery and Innovative Medicines (MedInUP), University of Porto, Porto, Portugal
Interests: inflammatory bowel disease; purinergic system; ENS; clinical research

Special Issue Information

Dear Colleagues,

Inflammatory bowel diseases (IBD) are characterized by chronic inflammation of the gastrointestinal tract, with two main clinical manifestations: Crohn's disease, whose pathogenesis involves any part of the gastrointestinal tract, and ulcerative colitis, in which inflammation is limited to the colon. This gastrointestinal tract inflammation leads to symptoms such as bleeding, abdominal pain, diarrhea, malnutrition, and increased intestinal permeability. Among the factors involved in the pathogenesis of these diseases, genetics, dysregulation in the intestinal microbiota and environmental factors such as diet and physical inactivity stand out. Considering the severity of symptoms related to IBD, alternative therapies have been sought to alleviate intestinal discomfort, and physical exercise, dietary interventions, and nutritional supplements can bring benefits, which include improving the composition of the microbiota, intestinal tract, and its antioxidant and anti-inflammatory action, which may have a protective action on the permeability in the gastrointestinal tract. This Research Topic aims to bring a collection of papers that approach the clinical diagnosis and treatment of IBD. We welcome the submission of manuscripts including, but not limited to, the following topics: Special focus will be given (but is not restricted) to clinical diagnosis of IBD; exercise or nutrition on IBD; microbiota and IBD; body composition on IBD.

Dr. Moisés Tolentino B. Da Silva
Dr. Isabel Silva
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gastrointestinal disorders
  • intestinal inflammation
  • intestinal bowel disease
  • nutrition
  • physical exercise
  • cancer
  • enteric nervous system
  • vagus nerve

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Published Papers (3 papers)

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Research

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10 pages, 768 KiB  
Article
Evaluation of Acute Terminal Ileitis in Hospitalized Patients: Development of a Predictive Model to Distinguish Crohn’s Disease from Other Etiologies
by Anton Bermont, Naim Abu-Freha, Refael Aminov, Sergei Vosko, Haim Shirin and Daniel L. Cohen
J. Clin. Med. 2024, 13(17), 5030; https://doi.org/10.3390/jcm13175030 - 25 Aug 2024
Viewed by 834
Abstract
Background/Objectives: Terminal ileitis (TI) is often identified on CT scans in emergency settings. Diagnosing Crohn’s disease (CD) as a cause of TI is crucial due to its significant long-term implications. This study aimed to differentiate CD from other causes of acute TI [...] Read more.
Background/Objectives: Terminal ileitis (TI) is often identified on CT scans in emergency settings. Diagnosing Crohn’s disease (CD) as a cause of TI is crucial due to its significant long-term implications. This study aimed to differentiate CD from other causes of acute TI and develop a predictive model for CD diagnosis. Methods: A retrospective case-control study was conducted at Shamir Medical Center including adults diagnosed with acute TI from January 2012 to December 2020. Patients with a history of inflammatory bowel disease or prior intestinal surgery were excluded. Patients were categorized into CD and non-CD groups based on their subsequent clinical course. A logistic regression model was developed and subsequently validated with additional patients hospitalized between 2021 and 2023. Results: Among 135 patients, 37 (27.4%) were diagnosed with CD. CD patients were younger (median age 27 vs. 39 years, p = 0.003), predominantly male (83.8% vs. 51%, p = 0.001), and had higher rates of chronic abdominal pain, diarrhea, anemia, and weight loss prior to hospitalization. Significant laboratory differences included higher platelet counts (p = 0.006) and lower mean corpuscular volume (MCV) (p = 0.001) in CD patients. Radiologic signs of complicated disease were more common in CD (35.1% vs. 4.1%, p < 0.001). The predictive model incorporating gender, abdominal pain history, and MCV showed an area under the curve (AUC) of 0.87, with a sensitivity of 100% and specificity of 63.6% in the validation group of 18 patients. Conclusions: This study identified key predictors of CD in patients presenting with acute TI and developed a predictive model with a substantial diagnostic capability. Use of this model for early identification and treatment of CD may potentially improve patient outcomes. Further prospective validation of this model is warranted. Full article
(This article belongs to the Special Issue Inflammatory Bowel Disease (IBD): Clinical Diagnosis and Treatment)
►▼ Show Figures

Figure 1

Figure 1
<p>Flowchart of the study population.</p> Full article ">Figure 2
<p>The area under the the receiver operating characteristic curve used to evaluate the discrimination ability of our model.</p> Full article ">Figure 3
<p>Box-and-whisker plot shows probability for CD. Bottom and top of boxes indicate 25th and 75th percentiles, respectively. Horizontal lines inside boxes indicate median values.</p> Full article ">
14 pages, 13276 KiB  
Article
Specific Oral Manifestations in Adults with Crohn’s Disease
by Yavuz Cagir, Muhammed Bahaddin Durak, Cem Simsek and Ilhami Yuksel
J. Clin. Med. 2024, 13(13), 3955; https://doi.org/10.3390/jcm13133955 - 5 Jul 2024
Cited by 1 | Viewed by 1104
Abstract
Background: Oral manifestations of Crohn’s disease (CD) include non-specific lesions and specific lesions directly related to intestinal inflammation. Oral lesions that can be overlooked in CD are sometimes challenging to treat. Methods: In this retrospective single-center study, patients with CD aged [...] Read more.
Background: Oral manifestations of Crohn’s disease (CD) include non-specific lesions and specific lesions directly related to intestinal inflammation. Oral lesions that can be overlooked in CD are sometimes challenging to treat. Methods: In this retrospective single-center study, patients with CD aged over 18 years who complied with follow-up and treatment were included. Clinical definitions of specific oral lesions included pyostomatitis vegetans, glossitis with fissuring, lip swelling with fissuring, cobblestoning, and orofacial granulomatosis. Experienced dentists confirmed the specific lesions in each case. Three groups of patients were identified: those without oral lesions, those with non-specific oral lesions, and those with specific oral lesions. The groups were compared based on demographics, disease extent and behavior (based on the Montreal classification), extraintestinal involvement, biologic and steroid treatment, and the requirement of resective surgery. Results: A total of 96 patients (14.2%) with oral lesions were found among the 676 patients with CD (59.7% male, median age 38 years) who were followed for 6.83 years (IQR 0.5–29.87 years). Eight patients (1.2%, 9 lesions) had specific oral lesions, while eighty-eight patients (13%) had non-specific lesions. Orofacial granulomatosis (n = 3), cobblestoning (n = 2), glossitis with fissuring (n = 2), and lip swelling with fissuring (n = 2) were among the specific lesions. The majority of patients (75%) with specific lesions were male, and their median age was 46.5 years (range: 23–68 years). Disease localization was commonly ileocolonic (50%), and perianal disease was present in 25% of patients. Three patients were active smokers. Extraintestinal manifestations were peripheral arthritis/arthralgia (n = 7) and sacroiliitis (n = 1). All specific lesions were associated with moderate-to-severe disease. Five patients improved with biologic therapy, and two patients with immunomodulatory therapy. Conclusions: Specific oral lesions in CD were associated with active disease and improved with immunomodulators or biologic therapy. Close cooperation between gastroenterologists and dentists is essential for early diagnosis and optimal management of CD. Full article
(This article belongs to the Special Issue Inflammatory Bowel Disease (IBD): Clinical Diagnosis and Treatment)
►▼ Show Figures

Figure 1

Figure 1
<p>(<b>a</b>). Cobblestoning on the palatal mucosa in a patient with Crohn’s disease before treatment. (<b>b</b>). Resolution of cobblestoning on the palatal mucosa following treatment with ustekinumab.</p> Full article ">Figure 2
<p>Orofacial granulomatosis.</p> Full article ">Figure 3
<p>(<b>a</b>). Glossitis with fissuring in a patient with Crohn’s disease before treatment. (<b>b</b>). Improvement in glossitis with fissuring after treatment with immunomodulatory monotherapy.</p> Full article ">Figure 4
<p>(<b>a</b>). Lip swelling with fissuring in a patient with Crohn’s disease before treatment. (<b>b</b>). Resolution of lip swelling with fissuring following treatment with a combination of immunomodulators and systemic steroids.</p> Full article ">Figure 5
<p>Persistent cobblestoning on the buccal mucosa in a patient with Crohn’s disease who declined biologic therapy.</p> Full article ">

Review

Jump to: Research

43 pages, 653 KiB  
Review
Common Mistakes in Managing Patients with Inflammatory Bowel Disease
by Javier P. Gisbert and María Chaparro
J. Clin. Med. 2024, 13(16), 4795; https://doi.org/10.3390/jcm13164795 - 14 Aug 2024
Viewed by 1279
Abstract
Introduction: Errors are very common in medical practice and in particular, in the healthcare of patients with inflammatory bowel disease (IBD); however, most of these can be prevented. Aim: To address common errors in the management of IBD. Methods: Our approach to this [...] Read more.
Introduction: Errors are very common in medical practice and in particular, in the healthcare of patients with inflammatory bowel disease (IBD); however, most of these can be prevented. Aim: To address common errors in the management of IBD. Methods: Our approach to this problem consists in identifying mistakes frequently observed in clinical practice (according to our experience) in the management of patients with IBD, then reviewing the scientific evidence available on the subject, and finally proposing the most appropriate recommendation for each case. Results: The most common mistakes in the management of IBD include those related to diagnosis and differential diagnosis, prevention, nutrition and diet, treatment with different drugs (mainly 5-aminosalicylates, corticosteroids, thiopurines, and anti-TNF agents), extraintestinal manifestations, anemia, elderly patients, pregnancy, and surgery. Conclusions: Despite the availability of guidelines for both disease management and preventive aspects of IBD care, a considerable variation in clinical practice still remains. In this review, we have identified common mistakes in the management of patients with IBD in clinical practice. There is a clear need for a greater dissemination of clinical practice guidelines among gastroenterologists and for the implementation of ongoing training activities supported by scientific societies. Finally, it is desirable to follow IBD patients in specialized units, which would undoubtedly be associated with higher-quality healthcare and a lower likelihood of errors in managing these patients. Full article
(This article belongs to the Special Issue Inflammatory Bowel Disease (IBD): Clinical Diagnosis and Treatment)
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