Mistakes in the medical management of IBD and how to avoid them

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Mistakes in the medical management of IBD and how to avoid them

Nik Ding, Tim Raine

Summary

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This article examines common clinical pitfalls in managing inflammatory bowel disease, a condition affecting 0.5% to 1% of the population with variable severity and unpredictable progression.

IBD presents unique healthcare challenges as it is too rare for primary care but sufficiently common for general gastroenterologists.
Disease severity ranges from mild symptoms to severe, disabling manifestations with unpredictable progression, requiring coordinated multidisciplinary management.
Recent advances in IBD pathogenesis understanding, diagnostics, therapies, and surgical techniques have significantly changed management approaches.
The material draws on evidence and clinical experience to highlight treatment complexities and suggest improvements in patient outcomes.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

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Abstract

Inflammatory bowel disease (IBD) affects approximately 0.5% to 1% of the population, a prevalence that challenges healthcare systems where it is too rare for primary care but common enough for general gastroenterologists. While some patients experience mild symptoms, others suffer from severe, disabling symptoms and unpredictable disease progression, necessitating a coordinated, multidisciplinary approach to management. Recent advances in understanding IBD pathogenesis, diagnostics, therapies, and surgical techniques have significantly changed IBD management. This Mistakes In article explores common pitfalls in treating IBD, highlighting the complexities and challenges faced by clinicians, and draws on evidence and clinical experience to suggest improvements in patient outcomes.

Topics

IBD

Citation

Raine T and Ding NS. Mistakes in the medical management of IBD and how to avoid them. UEG Education 2017; 17: 33–38.

Published

2024

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UEG Mistakes In Articles

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Mistakes in abdominal distension and how to avoid them

Elizabeth Barba Orozco, Alberto Ezquerra-Durán

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Abstract

Abdominal distension and bloating are among the most frequently misunderstood complaints in gastroenterology. They are often used as interchangeable terms, a conceptual mistake that continues to drive diagnostic errors and ineffective treatment. According to Rome IV, bloating and distension may represent either a primary disorder of gut–brain interaction (DGBI) or occur as symptoms with other DGBIs, such as irritable bowel syndrome (IBS), functional dyspepsia (FD) or functional constipation (FC).

Topics

Neurogastroenterology & Motility

Citation

Barba E and Ezquerra-Durán A. Mistakes in abdominal distension and bloating and how to avoid them. UEG Education 2026; 26: 5-9.

Published

2026

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Mistakes in abdominal distension and how to avoid them

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UEG Mistakes In Articles

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Mistakes in acute jaundice and how to avoid them

Spyridon Siakavellas, Georgios Papatheodoridis

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Abstract

Jaundice can be caused by abnormalities in any of the steps comprising the formation, metabolism and excretion of bilirubin. In addition, these processes may be functioning properly, but jaundice can be seen because of an obstruction of the biliary tree at any point, from its intrahepatic origins to its end at the ampulla of Vater. For this reason, it is clear that numerous conditions can result in jaundice. When faced with a patient presenting with jaundice a reasonable and careful diagnostic approach is, therefore, warranted to elucidate the underlying cause of this sign. Conventional wisdom may be that “jaundice by itself never killed anyone,” but it is imperative to find the cause as soon as possible, as prompt intervention saves lives in many cases.

Topics

Hepatobiliary

Citation

Siakavellas S and Papatheodoridis G. Mistakes in acute jaundice and how to avoid them. UEG Education 2018; 18: 24–26.

Published

2025

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Egle Dieninyte - Misiune

UEG Mistakes In Articles

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Mistakes in alcoholic liver disease and how to avoid them

Helena Cortez-Pinto, Pedro Marques Da Costa

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Abstract

Alcohol consumption is the most prevalent aetiology for liver cirrhosis in Europe and the third leading risk factor for overall mortality.1,2 In fact, alcoholic liver cirrhosis accounts for almost half a million deaths a year worldwide, corresponding to 50% of all cases of cirrhosis, according to the World Health Organization (WHO).3 Alcoholic liver disease (ALD) is multifaceted, with several cofactors influencing its progression. Patients abusing alcohol can simultaneously have viral hepatitis B or C, or a genetic disease, such as alpha-1 antitrypsin deficiency or haemochromatosis.

Topics

Hepatobiliary

Citation

Marques da Costa P and Cortez-Pinto H. Mistakes in alcoholic liver disease and how to avoid them. UEG Education 2017: 17; 10–14.

Published

2024

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Mistakes in hepatitis C and how to avoid them

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Mistakes in coagulation in liver disease and how to avoid them

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Ian Gralnek on UEG Week 2024

Egle Dieninyte - Misiune

UEG Mistakes In Articles

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Mistakes in hepatitis C and how to avoid them

Ana Catarina Garcia, Gonçalo Alexandrino

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Abstract

Hepatitis C virus (HCV) infection remains an important global health concern. It is estimated that there are approximately 50 million people infected with HCV globally, with around 1 million new infections each year and about 242,000 deaths annually attributed to HCV-related complications. Most acute HCV infections (55–85%) become chronic due to the virus’s effective evasion strategies, with spontaneous clearance being rare once chronicity is established. This condition often progresses silently, with many individuals unaware of their infection until advanced liver damage has occurred. If left untreated, HCV can lead to severe complications, including liver cirrhosis and hepatocellular carcinoma (HCC). HCV transmission occurs mainly through percutaneous exposure to infected blood. HCV can also spread from mother to infant (vertical transmission) and, less frequently, via sexual contact.1,2 In recent years, the introduction of oral direct-acting antivirals (DAAs), with remarkable safety and effectiveness profiles, has led to a sustained virological response (SVR) in virtually all (>97%) HCV-infected patients, regardless of HCV genotype or disease stage. However, significant barriers remain, such as issues with diagnosis, access to treatment and awareness of the disease.

Here, we discuss some of the misconceptions in HCV management and provide a practical management approach grounded in evidence and clinical experience.

Topics

Hepatobiliary

Citation

Garcia A.C and Alexandrino G. Mistakes in hepatits C and how to avoid them. UEG Education 2025; 25: 14-17.

Published

2025

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Alberto Ezquerra-Durán

Mistakes in acute jaundice and how to avoid them

Georgios Papatheodoridis

Mistakes in alcoholic liver disease and how to avoid them

Helena Cortez-Pinto

Mistakes in hepatitis C and how to avoid them

Gonçalo Alexandrino

Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

Ian Gralnek on UEG Week 2024

Egle Dieninyte - Misiune

UEG Mistakes In Articles

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This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

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Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

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References

Abstract

Alteration of common coagulation tests and thrombocytopenia represent an integral part of the clinical picture of patients with advanced chronic liver disease. As such, the International Normalised Ratio (INR) for prothrombin time is part of the Model for End-stage Liver Disease (MELD) score, which is commonly used to assess prognosis and the need for liver transplantation in patients with cirrhosis. Thrombocytopenia—being mainly related to hypersplenism and decreased synthesis of thrombopoietin by the liver—can also be used to identify the presence of portal hypertension and decreased liver function in patients with chronic liver disease.

Topics

Hepatobiliary

Citation

Giannini EG and Caldwell SH. Mistakes in coagulation in liver disease and how to avoid them. UEG Education 2021; 21: 29–34.

Published

2021

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UEG Podcast Episode

UEG Podcast

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Ian Gralnek on UEG Week 2024

Ian Mark Gralnek, Egle Dieninyte - Misiune

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Abstract

Topics

Endoscopy

Published

2025

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Mistakes in abdominal distension and how to avoid them

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