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Mistakes in newly diagnosed Crohn's disease and how to avoid them

Joana Roseira, Nurulamin Noor

Summary

AI Generated

This material reviews common management mistakes in newly diagnosed Crohn's disease and provides evidence-based guidance for clinicians.

  • Crohn's disease is a chronic inflammatory bowel condition that can develop at any age and presents with a wide range of intestinal and extra-intestinal manifestations.
  • The condition significantly impacts quality of life, including relationships, educational attainment, and work productivity.
  • The period around and after diagnosis involves the most upheaval for patients but also represents the greatest opportunity for effective intervention.
  • Several recent advances have had a major impact on optimal management of newly diagnosed Crohn's disease.
  • The material is intended for practising clinicians managing patients with a new Crohn's disease diagnosis.
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Thanks for your feedback.

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.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Card TR, Siffledeen J, Fleming KM. Are IBD patients more likely to have a prior diagnosis of irritable bowel syndrome? Report of a case‐control study in the General Practice Research Database. United European Gastroenterol J 2014; 2: 505–512. [Link]
2.
Jayasooriya N, Baillie S, Blackwell J, et al. Systematic review with meta-analysis: Time to diagnosis and the impact of delayed diagnosis on clinical outcomes in inflammatory bowel disease. Aliment Pharmacol Ther 2023; 57: 635–652. [Link]
3.
Cantoro L, Monterubbianesi R, Falasco G, et al. The Earlier You Find, the Better You Treat: Red Flags for Early Diagnosis of Inflammatory Bowel Disease. Diagnostics 2023; 13: 3183. [Link]
4.
Walker GJ, Lin S, Chanchlani N, et al. Quality improvement project identifies factors associated with delay in IBD diagnosis. Aliment Pharmacol Ther 2020; 52: 471–480. [Link]
5.
Danese S, Fiorino G, Mary JY, et al. Development of red flags index for early referral of adults with symptoms and signs suggestive of Crohn’s disease: An IOIBD initiative. J Crohns Colitis 2015; 9: 601–606. [Link]
6.
Fiorino G, Bonovas S, Gilardi D, et al. Validation of the Red Flags Index for Early Diagnosis of Crohn’s Disease: A Prospective Observational IG-IBD Study among General Practitioners. J Crohns Colitis 2020; 14: 1777–1779. [Link]
7.
Din S, Rodrigues A, Avery P, et al. Primary care diagnostic pathways for lower gastrointestinal symptoms. Lancet Gastroenterol Hepatol 2025; 10: 9–11. [Link]
8.
Dolinger M, Torres J, Vermeire S. Crohn’s disease. The Lancet 2024; 403: 1177–1191. [Link]
9.
Dubian S, Yzet C, Brazier F, et al. Fecal calprotectin, intestinal ultrasound, and their combination for the diagnosis of inflammatory bowel disease. Clin Res Hepatol Gastroenterol 2025; 49: 102549. [Link]
10.
Tyrode G, Rivière P, Sebastian S, et al. Systematic review: severe endoscopic lesions in inflammatory bowel disease. J Crohns Colitis 2025; 19: jjaf029. [Link]
11.
Magro F, Sabino J, Rosini F, et al. ECCO Position on harmonization of Crohn’s disease mucosal histopathology. J Crohns Colitis 2022; 16: 876–883. [Link]
12.
Feakins R, Torres J, Borralho-Nunes P, et al. ECCO Topical Review on Clinicopathological Spectrum and Differential Diagnosis of Inflammatory Bowel Disease. J Crohns Colitis 2022; 16: 343–368. [Link]
13.
Kim OZ, Han DS, Park CH, et al. The Clinical Characteristics and Prognosis of Crohn’s Disease in Korean Patients Showing Proximal Small Bowel Involvement: Results from the CONNECT Study. Gut Liver 2018; 12: 67–72. [Link]
14.
Hansel SL, McCurdy JD, Barlow JM, et al. Clinical Benefit of Capsule Endoscopy in Crohn’s Disease: Impact on Patient Management and Prevalence of Proximal Small Bowel Involvement. Inflamm Bowel Dis 2018; 24: 1582–1588. [Link]
15.
Tsai L, McCurdy JD, Ma C, et al. Epidemiology and Natural History of Perianal Crohn’s Disease: A Systematic Review and Meta-Analysis of Population-Based Cohorts. Inflamm Bowel Dis 2022; 28: 1477-1484. [Link]
16.
Hanna LN, Munster LJ, Joshi S, et al. Isolated perianal Crohn’s disease: a systematic review and expert consensus proposing novel diagnostic criteria and management advice. Lancet Gastroenterol Hepatol 2025; 10: 757-768. [Link]
17.
Yamamoto T, Nakase H, Watanabe K, et al. Diagnosis and Clinical Features of Perianal Lesions in Newly Diagnosed Crohn’s Disease: Subgroup Analysis from Inception Cohort Registry Study of Patients with Crohn’s Disease (iCREST-CD). J Crohns Colitis 2023; 17: 1193–1206. [Link]
18.
Schwartz DA, Lightner AL, Aswani-Omprakash T, et al. Better Together: Implementing a Multidisciplinary Approach to Optimizing Diagnosis and Management of Crohn’s Perianal Fistulas. Gastroenterology 2025; 168: 640-644.e1. [Link]
19.
Gordon H, Burisch J, Ellul P, et al. ECCO Guidelines on Extraintestinal Manifestations in Inflammatory Bowel Disease. J Crohns Colitis 2024; 18: 1-37. [Link]
20.
Danese S, Solitano V, Jairath V, et al. The future of drug development for inflammatory bowel disease: the need to ACT (advanced combination treatment). Gut 2022; 71: 2380–2387. [Link]
21.
Nardone OM, Noor NM, Prabhu A, et al. The Effectiveness of Medical Therapies for Joint, Skin and Eye Extraintestinal Manifestations in IBD—An Umbrella Review. Aliment Pharmacol Ther 2025; 61: 1854–1871. [Link]
22.
Moulton CD, Jordan C, Hayee B, et al. All-or-Nothing Behavior and Catastrophic Thinking Predict Fatigue in Inflammatory Bowel Disease: A Prospective Cohort Study. Inflamm Bowel Dis 2024; 30: 1903–1906. [Link]
23.
Fitzpatrick JA, Melton SL, Yao CK, et al. Dietary management of adults with IBD — the emerging role of dietary therapy. Nat Rev Gastroenterol Hepatol 2022; 19: 652–669. [Link]
24.
Oliveira R, Martins V, de Sousa HT, et al. Food-Related Quality of Life and Its Predictors in Inflammatory Bowel Disease. Dig Dis Sci 2024; 69: 1793–1802. [Link]
25.
Narula N, Wong ECL, Dehghan M, et al. Association of ultra-processed food intake with risk of inflammatory bowel disease: prospective cohort study. BMJ 2021; 374: n1554. [Link]
26.
Grover Z, Burgess C, Muir R, et al. Early mucosal healing with exclusive enteral nutrition is associated with improved outcomes in newly diagnosed children with Luminal Crohn’s disease. J Crohns Colitis 2016; 10: 1159–1164. [Link]
27.
Cohen-Dolev N, Sladek M, Hussey S, et al. Differences in outcomes over time with exclusive enteral nutrition compared with steroids in children with mild to moderate Crohn’s disease: Results from the GROWTH CD study. J Crohns Colitis 2018; 12: 306–312. [Link]
28.
Heerasing N, Thompson B, Hendy P, et al. Exclusive enteral nutrition provides an effective bridge to safer interval elective surgery for adults with Crohn’s disease. Aliment Pharmacol Ther 2017; 45: 660–669. [Link]
29.
Ananthakrishnan AN, Whelan K, Allegretti JR, et al. Diet and Microbiome-Directed Therapy 2.0 for IBD. Clin Gastroenterol Hepatol 2025; 23: 406–418. [Link]
30.
Jacobsen HA, Karachalia-Sandri A, Ebert AC, et al. Prevalence and Prognosis of Mild Inflammatory Bowel Disease: A Population-based Cohort Study, 1997–2020. Clin Gastroenterol Hepatol. Epub ahead of print December 2024. DOI: 10.1016/j.cgh.2024.10.021. [Link]
31.
Yanai H, Levine A, Hirsch A, et al. The Crohn’s disease exclusion diet for induction and maintenance of remission in adults with mild-to-moderate Crohn’s disease (CDED-AD): an open-label, pilot, randomised trial. Lancet Gastroenterol Hepatol 2022; 7: 49–59. [Link]
32.
Lewis JD, Sandler RS, Brotherton C, et al. A Randomized Trial Comparing the Specific Carbohydrate Diet to a Mediterranean Diet in Adults With Crohn’s Disease. Gastroenterology 2021; 161: 837-852.e9. [Link]
33.
Gordon H, Minozzi S, Kopylov U, et al. ECCO Guidelines on Therapeutics in Crohn’s Disease: Medical Treatment. J Crohns Colitis 2024; 18: 1531-1555. [Link]
34.
Gibson PR, Yao CK, Halmos EP. Review article: Evidence‐based dietary management of inflammatory bowel disease. Aliment Pharmacol Ther 2024; 60: 1215–1233. [Link]
35.
Eldridge F, Raine T. Understanding and Addressing the Psychological Burden of IBD. J Crohns Colitis 2022; 16: 177–178. [Link]
36.
Barberio B, Zamani M, Black CJ, et al. Prevalence of symptoms of anxiety and depression in patients with inflammatory bowel disease: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2021; 6: 359–370. [Link]
37.
Roseira J, Magro F, Fernandes S, et al. Sexual Quality of Life in Inflammatory Bowel Disease: A Multicenter, National-Level Study. Inflamm Bowel Dis 2020; 26: 746-755. [Link]
38.
Bernabeu P, Belén-Galipienso O, van-der Hofstadt C, et al. Psychological burden and quality of life in newly diagnosed inflammatory bowel disease patients. Front Psychol 2024; 15: 1334308 [Link]
39.
Taft TH, Quinton S, Jedel S, et al. Posttraumatic Stress in Patients With Inflammatory Bowel Disease: Prevalence and Relationships to Patient-Reported Outcomes. Inflamm Bowel Dis 2022; 28: 710–719. [Link]
40.
Fairbrass KM, Lovatt J, Barberio B, et al. Bidirectional brain–gut axis effects influence mood and prognosis in IBD: a systematic review and meta-analysis. Gut 2022; 71: 1773–1780. [Link]
41.
Cosnes J, Cattan S, Blain A, et al. Long-term evolution of disease behavior of Crohn’s disease. Inflamm Bowel Dis 2002; 8: 244–250. [Link]
42.
Pariente B, Cosnes J, Danese S, et al. Development of the Crohn’s disease digestive damage score, the Lémann score. Inflamm Bowel Dis 2011; 17: 1415–1422. [Link]
43.
Siegel CA, Sharma D, Griffith J, et al. Treatment Pathways in Patients With Crohn’s Disease and Ulcerative Colitis: Understanding the Road to Advanced Therapy. Crohns Colitis 360 2024; 6: otae040. [Link]
44.
Lim W-C, Wang Y, MacDonald JK, et al. Aminosalicylates for induction of remission or response in Crohn’s disease. Cochrane Database Syst Rev 2016; 7: CD008870. [Link]
45.
Lamb CA, Kennedy NA, Raine T, et al. British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut 2019; 68: S1-106. [Link]
46.
Al Sulais E, Louis E, Bokemeyer B, et al. Differences in the Adverse Event Burden of Corticosteroid Use in Inflammatory Bowel Disease as Reported Between Adverse Event Reporting Systems and a Patient Questionnaire. J Crohns Colitis 2025; 19: jjae138. [Link]
47.
Lichtenstein GR, Feagan BG, Cohen RD, et al. Serious infection and mortality in patients with crohn’s disease: More than 5 years of follow-up in the TREAT registry. Am J Gastroenterol 2012; 107: 1409–1422. [Link]
48.
Blackwell J, Selinger C, Raine T, et al. Steroid use and misuse: a key performance indicator in the management of IBD. Frontline Gastroenterol 2021; 12: 207–213. [Link]
49.
Noor NM, Sousa P, Paul S, et al. Early Diagnosis, Early Stratification, and Early Intervention to Deliver Precision Medicine in IBD. Inflamm Bowel Dis 2022; 28: 1254–1264. [Link]
50.
D’Haens G, Baert F, van Assche G, et al. Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn’s disease: an open randomised trial. Lancet 2008; 371: 660–667. [Link]
51.
Colombel JF, Panaccione R, Bossuyt P, et al. Effect of tight control management on Crohn’s disease (CALM): a multicentre, randomised, controlled phase 3 trial. Lancet 2017; 390: 2779–2789. [Link]
52.
Revés J, Fernandez-Clotet A, Ordás I, et al. Early Biological Therapy Within 12 Months of Diagnosis Leads to Higher Transmural Healing Rates in Crohn’s Disease. Clin Gastroenterol Hepatol 2025; 23: 1194-1203e2. [Link]
53.
Noor NM, Lee JC, Bond S, et al. A biomarker-stratified comparison of top-down versus accelerated step-up treatment strategies for patients with newly diagnosed Crohn’s disease (PROFILE): a multicentre, open-label randomised controlled trial. Lancet Gastroenterol Hepatol 2024; 9: 415–427. [Link]
54.
Ahuja D, Luo J, Qi Y, et al. Impact of Treatment Response on Risk of Serious Infections in Patients With Crohn’s Disease: Secondary Analysis of the PYRAMID Registry. Clin Gastroenterol Hepatol 2024; 22: 1286-1294. [Link]
55.
Jongsma MME, Aardoom MA, Cozijnsen MA, et al. First-line treatment with infliximab versus conventional treatment in children with newly diagnosed moderate-to-severe Crohn’s disease: An open-label multicentre randomised controlled trial. Gut 2022; 71: 34–42. [Link]
56.
Adler J, Gadepalli S, Rahman M, et al. Early tumour necrosis factor antagonist treatment prevents perianal fistula development in children with Crohn’s disease: post hoc analysis of the RISK study. Gut 2025; 74: 539-546. [Link]
57.
Noor NM, Bourke A, Subramanian S. Review article: Novel therapies in inflammatory bowel disease – An update for clinicians. Aliment Pharmacol Ther 2024; 60: 1244–1260. [Link]
58.
Ponsioen CY, de Groof EJ, Eshuis EJ, et al. Laparoscopic ileocaecal resection versus infliximab for terminal ileitis in Crohn’s disease: a randomised controlled, open-label, multicentre trial. Lancet Gastroenterol Hepatol 2017; 2: 785–792. [Link]
59.
Agrawal M, Ebert AC, Poulsen G, et al. Early Ileocecal Resection for Crohn’s Disease Is Associated With Improved Long-term Outcomes Compared With Anti-Tumor Necrosis Factor Therapy: A Population-Based Cohort Study. Gastroenterology 2023; 165: 976-985.e3. [Link]
60.
Grellier N, Kirchgesner J, Uzzan M, et al. Early ileal resection in Crohn’s disease is not associated with severe long‐term outcomes: The ERIC study. Aliment Pharmacol Ther 2024; 60: 1388–1397. [Link]
61.
Adamina M, Minozzi S, Warusavitarne J, et al. ECCO Guidelines on Therapeutics in Crohn’s Disease: Surgical Treatment. J Crohns Colitis 2024; 18: 1556-1582. [Link]
62.
Zaman S, Mohamedahmed AYY, Abdelrahman W, et al. Minimally Invasive Surgery for Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis of Robotic Versus Laparoscopic Surgical Techniques. J Crohns Colitis 2024; 18: 1342–1355. [Link]
63.
Buskens CJ, Bemelman WA. The surgeon and inflammatory bowel disease. British Journal of Surgery 2019; 106: 1118–1119. [Link]
64.
D’Amico F, Gomollón F, Bamias G, et al. Proportion of inflammatory bowel diseases patients with suboptimal disease control in daily clinical practice—Real‐world evidence from the inflammatory bowel diseases‐podcast study. United European Gastroenterol J 2024; 12: 705–716. [Link]
65.
De Cruz P, Kamm MA, Hamilton AL, et al. Crohn’s disease management after intestinal resection: a randomised trial. The Lancet 2015; 385: 1406–1417. [Link]
66.
Turner D, Ricciuto A, Lewis A, et al. STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD. Gastroenterology 2021; 160: 1570–1583. [Link]
67.
Wilkens R, Dolinger M, Burisch J, et al. Point-of-Care Testing and Home Testing: Pragmatic Considerations for Widespread Incorporation of Stool Tests, Serum Tests, and Intestinal Ultrasound. Gastroenterology 2022; 162: 1476–1479. [Link]
68.
Ernest-Suárez K, Noor NM. Not All Transmural Healing is Equal in Crohn’s Disease: Magnetic Resonance Enterography and Intestinal Ultrasound for Stricture Assessment in the STRIDENT Trial. Inflamm Bowel Dis 2025; 31: 2318-2320. [Link]
69.
Sharip MT, Brezina B, De La Revilla Negro J, et al. A Treat-to-Target Approach in IBD: Contemporary Real-World Perspectives from an International Survey. J Clin Med 2025; 14: 667. [Link]
70.
Singh S, Nguyen JD, Fudman DI, et al. Treat-to-target of endoscopic remission in patients with inflammatory bowel disease in symptomatic remission on advanced therapies (QUOTIENT): rationale, design and protocol for an open-label, multicentre, pragmatic, randomised controlled trial. BMJ Open Gastroenterol 2025; 12: e001615. [Link]

Abstract

Crohn’s disease (CD) is a chronic inflammatory bowel condition that can present with a wide range of intestinal and extra-intestinal manifestations. This condition can develop at any age and have a significant impact and impairment on quality of life for individuals including on relationships, educational attainment and work productivity. In particular, the time around and after diagnosis often involves the most upheaval for patients, and equally the biggest opportunity for effective intervention. Several recent advances have had a major impact on optimal management of patients with newly diagnosed CD. Here, we discuss the mistakes that are commonly made when managing patients presenting with a new diagnosis of CD. We summarise the evidence base and offer helpful and pragmatic tips for practising clinicians.

Topics

IBD

Citation

Roseira J and Noor N. Mistakes in newly diagnosed crohn's disease and how to avoid them. UEG Education 2025; 25: 18-23.

Published

2025

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Thanks for your feedback.

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.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Card TR, Siffledeen J, Fleming KM. Are IBD patients more likely to have a prior diagnosis of irritable bowel syndrome? Report of a case‐control study in the General Practice Research Database. United European Gastroenterol J 2014; 2: 505–512. [Link]
2.
Jayasooriya N, Baillie S, Blackwell J, et al. Systematic review with meta-analysis: Time to diagnosis and the impact of delayed diagnosis on clinical outcomes in inflammatory bowel disease. Aliment Pharmacol Ther 2023; 57: 635–652. [Link]
3.
Cantoro L, Monterubbianesi R, Falasco G, et al. The Earlier You Find, the Better You Treat: Red Flags for Early Diagnosis of Inflammatory Bowel Disease. Diagnostics 2023; 13: 3183. [Link]
4.
Walker GJ, Lin S, Chanchlani N, et al. Quality improvement project identifies factors associated with delay in IBD diagnosis. Aliment Pharmacol Ther 2020; 52: 471–480. [Link]
5.
Danese S, Fiorino G, Mary JY, et al. Development of red flags index for early referral of adults with symptoms and signs suggestive of Crohn’s disease: An IOIBD initiative. J Crohns Colitis 2015; 9: 601–606. [Link]
6.
Fiorino G, Bonovas S, Gilardi D, et al. Validation of the Red Flags Index for Early Diagnosis of Crohn’s Disease: A Prospective Observational IG-IBD Study among General Practitioners. J Crohns Colitis 2020; 14: 1777–1779. [Link]
7.
Din S, Rodrigues A, Avery P, et al. Primary care diagnostic pathways for lower gastrointestinal symptoms. Lancet Gastroenterol Hepatol 2025; 10: 9–11. [Link]
8.
Dolinger M, Torres J, Vermeire S. Crohn’s disease. The Lancet 2024; 403: 1177–1191. [Link]
9.
Dubian S, Yzet C, Brazier F, et al. Fecal calprotectin, intestinal ultrasound, and their combination for the diagnosis of inflammatory bowel disease. Clin Res Hepatol Gastroenterol 2025; 49: 102549. [Link]
10.
Tyrode G, Rivière P, Sebastian S, et al. Systematic review: severe endoscopic lesions in inflammatory bowel disease. J Crohns Colitis 2025; 19: jjaf029. [Link]
11.
Magro F, Sabino J, Rosini F, et al. ECCO Position on harmonization of Crohn’s disease mucosal histopathology. J Crohns Colitis 2022; 16: 876–883. [Link]
12.
Feakins R, Torres J, Borralho-Nunes P, et al. ECCO Topical Review on Clinicopathological Spectrum and Differential Diagnosis of Inflammatory Bowel Disease. J Crohns Colitis 2022; 16: 343–368. [Link]
13.
Kim OZ, Han DS, Park CH, et al. The Clinical Characteristics and Prognosis of Crohn’s Disease in Korean Patients Showing Proximal Small Bowel Involvement: Results from the CONNECT Study. Gut Liver 2018; 12: 67–72. [Link]
14.
Hansel SL, McCurdy JD, Barlow JM, et al. Clinical Benefit of Capsule Endoscopy in Crohn’s Disease: Impact on Patient Management and Prevalence of Proximal Small Bowel Involvement. Inflamm Bowel Dis 2018; 24: 1582–1588. [Link]
15.
Tsai L, McCurdy JD, Ma C, et al. Epidemiology and Natural History of Perianal Crohn’s Disease: A Systematic Review and Meta-Analysis of Population-Based Cohorts. Inflamm Bowel Dis 2022; 28: 1477-1484. [Link]
16.
Hanna LN, Munster LJ, Joshi S, et al. Isolated perianal Crohn’s disease: a systematic review and expert consensus proposing novel diagnostic criteria and management advice. Lancet Gastroenterol Hepatol 2025; 10: 757-768. [Link]
17.
Yamamoto T, Nakase H, Watanabe K, et al. Diagnosis and Clinical Features of Perianal Lesions in Newly Diagnosed Crohn’s Disease: Subgroup Analysis from Inception Cohort Registry Study of Patients with Crohn’s Disease (iCREST-CD). J Crohns Colitis 2023; 17: 1193–1206. [Link]
18.
Schwartz DA, Lightner AL, Aswani-Omprakash T, et al. Better Together: Implementing a Multidisciplinary Approach to Optimizing Diagnosis and Management of Crohn’s Perianal Fistulas. Gastroenterology 2025; 168: 640-644.e1. [Link]
19.
Gordon H, Burisch J, Ellul P, et al. ECCO Guidelines on Extraintestinal Manifestations in Inflammatory Bowel Disease. J Crohns Colitis 2024; 18: 1-37. [Link]
20.
Danese S, Solitano V, Jairath V, et al. The future of drug development for inflammatory bowel disease: the need to ACT (advanced combination treatment). Gut 2022; 71: 2380–2387. [Link]
21.
Nardone OM, Noor NM, Prabhu A, et al. The Effectiveness of Medical Therapies for Joint, Skin and Eye Extraintestinal Manifestations in IBD—An Umbrella Review. Aliment Pharmacol Ther 2025; 61: 1854–1871. [Link]
22.
Moulton CD, Jordan C, Hayee B, et al. All-or-Nothing Behavior and Catastrophic Thinking Predict Fatigue in Inflammatory Bowel Disease: A Prospective Cohort Study. Inflamm Bowel Dis 2024; 30: 1903–1906. [Link]
23.
Fitzpatrick JA, Melton SL, Yao CK, et al. Dietary management of adults with IBD — the emerging role of dietary therapy. Nat Rev Gastroenterol Hepatol 2022; 19: 652–669. [Link]
24.
Oliveira R, Martins V, de Sousa HT, et al. Food-Related Quality of Life and Its Predictors in Inflammatory Bowel Disease. Dig Dis Sci 2024; 69: 1793–1802. [Link]
25.
Narula N, Wong ECL, Dehghan M, et al. Association of ultra-processed food intake with risk of inflammatory bowel disease: prospective cohort study. BMJ 2021; 374: n1554. [Link]
26.
Grover Z, Burgess C, Muir R, et al. Early mucosal healing with exclusive enteral nutrition is associated with improved outcomes in newly diagnosed children with Luminal Crohn’s disease. J Crohns Colitis 2016; 10: 1159–1164. [Link]
27.
Cohen-Dolev N, Sladek M, Hussey S, et al. Differences in outcomes over time with exclusive enteral nutrition compared with steroids in children with mild to moderate Crohn’s disease: Results from the GROWTH CD study. J Crohns Colitis 2018; 12: 306–312. [Link]
28.
Heerasing N, Thompson B, Hendy P, et al. Exclusive enteral nutrition provides an effective bridge to safer interval elective surgery for adults with Crohn’s disease. Aliment Pharmacol Ther 2017; 45: 660–669. [Link]
29.
Ananthakrishnan AN, Whelan K, Allegretti JR, et al. Diet and Microbiome-Directed Therapy 2.0 for IBD. Clin Gastroenterol Hepatol 2025; 23: 406–418. [Link]
30.
Jacobsen HA, Karachalia-Sandri A, Ebert AC, et al. Prevalence and Prognosis of Mild Inflammatory Bowel Disease: A Population-based Cohort Study, 1997–2020. Clin Gastroenterol Hepatol. Epub ahead of print December 2024. DOI: 10.1016/j.cgh.2024.10.021. [Link]
31.
Yanai H, Levine A, Hirsch A, et al. The Crohn’s disease exclusion diet for induction and maintenance of remission in adults with mild-to-moderate Crohn’s disease (CDED-AD): an open-label, pilot, randomised trial. Lancet Gastroenterol Hepatol 2022; 7: 49–59. [Link]
32.
Lewis JD, Sandler RS, Brotherton C, et al. A Randomized Trial Comparing the Specific Carbohydrate Diet to a Mediterranean Diet in Adults With Crohn’s Disease. Gastroenterology 2021; 161: 837-852.e9. [Link]
33.
Gordon H, Minozzi S, Kopylov U, et al. ECCO Guidelines on Therapeutics in Crohn’s Disease: Medical Treatment. J Crohns Colitis 2024; 18: 1531-1555. [Link]
34.
Gibson PR, Yao CK, Halmos EP. Review article: Evidence‐based dietary management of inflammatory bowel disease. Aliment Pharmacol Ther 2024; 60: 1215–1233. [Link]
35.
Eldridge F, Raine T. Understanding and Addressing the Psychological Burden of IBD. J Crohns Colitis 2022; 16: 177–178. [Link]
36.
Barberio B, Zamani M, Black CJ, et al. Prevalence of symptoms of anxiety and depression in patients with inflammatory bowel disease: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2021; 6: 359–370. [Link]
37.
Roseira J, Magro F, Fernandes S, et al. Sexual Quality of Life in Inflammatory Bowel Disease: A Multicenter, National-Level Study. Inflamm Bowel Dis 2020; 26: 746-755. [Link]
38.
Bernabeu P, Belén-Galipienso O, van-der Hofstadt C, et al. Psychological burden and quality of life in newly diagnosed inflammatory bowel disease patients. Front Psychol 2024; 15: 1334308 [Link]
39.
Taft TH, Quinton S, Jedel S, et al. Posttraumatic Stress in Patients With Inflammatory Bowel Disease: Prevalence and Relationships to Patient-Reported Outcomes. Inflamm Bowel Dis 2022; 28: 710–719. [Link]
40.
Fairbrass KM, Lovatt J, Barberio B, et al. Bidirectional brain–gut axis effects influence mood and prognosis in IBD: a systematic review and meta-analysis. Gut 2022; 71: 1773–1780. [Link]
41.
Cosnes J, Cattan S, Blain A, et al. Long-term evolution of disease behavior of Crohn’s disease. Inflamm Bowel Dis 2002; 8: 244–250. [Link]
42.
Pariente B, Cosnes J, Danese S, et al. Development of the Crohn’s disease digestive damage score, the Lémann score. Inflamm Bowel Dis 2011; 17: 1415–1422. [Link]
43.
Siegel CA, Sharma D, Griffith J, et al. Treatment Pathways in Patients With Crohn’s Disease and Ulcerative Colitis: Understanding the Road to Advanced Therapy. Crohns Colitis 360 2024; 6: otae040. [Link]
44.
Lim W-C, Wang Y, MacDonald JK, et al. Aminosalicylates for induction of remission or response in Crohn’s disease. Cochrane Database Syst Rev 2016; 7: CD008870. [Link]
45.
Lamb CA, Kennedy NA, Raine T, et al. British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut 2019; 68: S1-106. [Link]
46.
Al Sulais E, Louis E, Bokemeyer B, et al. Differences in the Adverse Event Burden of Corticosteroid Use in Inflammatory Bowel Disease as Reported Between Adverse Event Reporting Systems and a Patient Questionnaire. J Crohns Colitis 2025; 19: jjae138. [Link]
47.
Lichtenstein GR, Feagan BG, Cohen RD, et al. Serious infection and mortality in patients with crohn’s disease: More than 5 years of follow-up in the TREAT registry. Am J Gastroenterol 2012; 107: 1409–1422. [Link]
48.
Blackwell J, Selinger C, Raine T, et al. Steroid use and misuse: a key performance indicator in the management of IBD. Frontline Gastroenterol 2021; 12: 207–213. [Link]
49.
Noor NM, Sousa P, Paul S, et al. Early Diagnosis, Early Stratification, and Early Intervention to Deliver Precision Medicine in IBD. Inflamm Bowel Dis 2022; 28: 1254–1264. [Link]
50.
D’Haens G, Baert F, van Assche G, et al. Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn’s disease: an open randomised trial. Lancet 2008; 371: 660–667. [Link]
51.
Colombel JF, Panaccione R, Bossuyt P, et al. Effect of tight control management on Crohn’s disease (CALM): a multicentre, randomised, controlled phase 3 trial. Lancet 2017; 390: 2779–2789. [Link]
52.
Revés J, Fernandez-Clotet A, Ordás I, et al. Early Biological Therapy Within 12 Months of Diagnosis Leads to Higher Transmural Healing Rates in Crohn’s Disease. Clin Gastroenterol Hepatol 2025; 23: 1194-1203e2. [Link]
53.
Noor NM, Lee JC, Bond S, et al. A biomarker-stratified comparison of top-down versus accelerated step-up treatment strategies for patients with newly diagnosed Crohn’s disease (PROFILE): a multicentre, open-label randomised controlled trial. Lancet Gastroenterol Hepatol 2024; 9: 415–427. [Link]
54.
Ahuja D, Luo J, Qi Y, et al. Impact of Treatment Response on Risk of Serious Infections in Patients With Crohn’s Disease: Secondary Analysis of the PYRAMID Registry. Clin Gastroenterol Hepatol 2024; 22: 1286-1294. [Link]
55.
Jongsma MME, Aardoom MA, Cozijnsen MA, et al. First-line treatment with infliximab versus conventional treatment in children with newly diagnosed moderate-to-severe Crohn’s disease: An open-label multicentre randomised controlled trial. Gut 2022; 71: 34–42. [Link]
56.
Adler J, Gadepalli S, Rahman M, et al. Early tumour necrosis factor antagonist treatment prevents perianal fistula development in children with Crohn’s disease: post hoc analysis of the RISK study. Gut 2025; 74: 539-546. [Link]
57.
Noor NM, Bourke A, Subramanian S. Review article: Novel therapies in inflammatory bowel disease – An update for clinicians. Aliment Pharmacol Ther 2024; 60: 1244–1260. [Link]
58.
Ponsioen CY, de Groof EJ, Eshuis EJ, et al. Laparoscopic ileocaecal resection versus infliximab for terminal ileitis in Crohn’s disease: a randomised controlled, open-label, multicentre trial. Lancet Gastroenterol Hepatol 2017; 2: 785–792. [Link]
59.
Agrawal M, Ebert AC, Poulsen G, et al. Early Ileocecal Resection for Crohn’s Disease Is Associated With Improved Long-term Outcomes Compared With Anti-Tumor Necrosis Factor Therapy: A Population-Based Cohort Study. Gastroenterology 2023; 165: 976-985.e3. [Link]
60.
Grellier N, Kirchgesner J, Uzzan M, et al. Early ileal resection in Crohn’s disease is not associated with severe long‐term outcomes: The ERIC study. Aliment Pharmacol Ther 2024; 60: 1388–1397. [Link]
61.
Adamina M, Minozzi S, Warusavitarne J, et al. ECCO Guidelines on Therapeutics in Crohn’s Disease: Surgical Treatment. J Crohns Colitis 2024; 18: 1556-1582. [Link]
62.
Zaman S, Mohamedahmed AYY, Abdelrahman W, et al. Minimally Invasive Surgery for Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis of Robotic Versus Laparoscopic Surgical Techniques. J Crohns Colitis 2024; 18: 1342–1355. [Link]
63.
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65.
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66.
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67.
Wilkens R, Dolinger M, Burisch J, et al. Point-of-Care Testing and Home Testing: Pragmatic Considerations for Widespread Incorporation of Stool Tests, Serum Tests, and Intestinal Ultrasound. Gastroenterology 2022; 162: 1476–1479. [Link]
68.
Ernest-Suárez K, Noor NM. Not All Transmural Healing is Equal in Crohn’s Disease: Magnetic Resonance Enterography and Intestinal Ultrasound for Stricture Assessment in the STRIDENT Trial. Inflamm Bowel Dis 2025; 31: 2318-2320. [Link]
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70.
Singh S, Nguyen JD, Fudman DI, et al. Treat-to-target of endoscopic remission in patients with inflammatory bowel disease in symptomatic remission on advanced therapies (QUOTIENT): rationale, design and protocol for an open-label, multicentre, pragmatic, randomised controlled trial. BMJ Open Gastroenterol 2025; 12: e001615. [Link]

Abstract

Peritoneal malignancies represent a complex and often misjudged clinical challenge. Historically synonymous with a terminal diagnosis, the advent of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) radically altered the prognosis for selected patients. However, progress has been jeopardised by a series of recurring and preventable errors in diagnosis, staging, and treatment selection. This article delineates the ten most critical pitfalls in managing peritoneal surface malignancies. For each pitfall, we provide evidence-based explanations, concrete clinical examples, and strategic recommendations for avoidance. We emphasise the pivotal role of early multidisciplinary discussion, precise imaging, and timely referral to high-volume expert centres to optimise patient outcomes and offer curative intent where previously there was none.

Topics

Digestive Oncology Surgery

Published

2026

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Coeliac disease with David Sanders

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Abstract

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Small Intestine & Nutrition

Published

2026

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UEG Mistakes In Articles
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Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Miroslav Vujasinovic, J. Enrique Domínguez Muñoz, Matthias Löhr

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References

Mistakes
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17.
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19.
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20.
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21.
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23.
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24.
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25.
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26.
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27.
Cohen-Dolev N, Sladek M, Hussey S, et al. Differences in outcomes over time with exclusive enteral nutrition compared with steroids in children with mild to moderate Crohn’s disease: Results from the GROWTH CD study. J Crohns Colitis 2018; 12: 306–312. [Link]
28.
Heerasing N, Thompson B, Hendy P, et al. Exclusive enteral nutrition provides an effective bridge to safer interval elective surgery for adults with Crohn’s disease. Aliment Pharmacol Ther 2017; 45: 660–669. [Link]
29.
Ananthakrishnan AN, Whelan K, Allegretti JR, et al. Diet and Microbiome-Directed Therapy 2.0 for IBD. Clin Gastroenterol Hepatol 2025; 23: 406–418. [Link]
30.
Jacobsen HA, Karachalia-Sandri A, Ebert AC, et al. Prevalence and Prognosis of Mild Inflammatory Bowel Disease: A Population-based Cohort Study, 1997–2020. Clin Gastroenterol Hepatol. Epub ahead of print December 2024. DOI: 10.1016/j.cgh.2024.10.021. [Link]
31.
Yanai H, Levine A, Hirsch A, et al. The Crohn’s disease exclusion diet for induction and maintenance of remission in adults with mild-to-moderate Crohn’s disease (CDED-AD): an open-label, pilot, randomised trial. Lancet Gastroenterol Hepatol 2022; 7: 49–59. [Link]
32.
Lewis JD, Sandler RS, Brotherton C, et al. A Randomized Trial Comparing the Specific Carbohydrate Diet to a Mediterranean Diet in Adults With Crohn’s Disease. Gastroenterology 2021; 161: 837-852.e9. [Link]
33.
Gordon H, Minozzi S, Kopylov U, et al. ECCO Guidelines on Therapeutics in Crohn’s Disease: Medical Treatment. J Crohns Colitis 2024; 18: 1531-1555. [Link]
34.
Gibson PR, Yao CK, Halmos EP. Review article: Evidence‐based dietary management of inflammatory bowel disease. Aliment Pharmacol Ther 2024; 60: 1215–1233. [Link]
35.
Eldridge F, Raine T. Understanding and Addressing the Psychological Burden of IBD. J Crohns Colitis 2022; 16: 177–178. [Link]
36.
Barberio B, Zamani M, Black CJ, et al. Prevalence of symptoms of anxiety and depression in patients with inflammatory bowel disease: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2021; 6: 359–370. [Link]
37.
Roseira J, Magro F, Fernandes S, et al. Sexual Quality of Life in Inflammatory Bowel Disease: A Multicenter, National-Level Study. Inflamm Bowel Dis 2020; 26: 746-755. [Link]
38.
Bernabeu P, Belén-Galipienso O, van-der Hofstadt C, et al. Psychological burden and quality of life in newly diagnosed inflammatory bowel disease patients. Front Psychol 2024; 15: 1334308 [Link]
39.
Taft TH, Quinton S, Jedel S, et al. Posttraumatic Stress in Patients With Inflammatory Bowel Disease: Prevalence and Relationships to Patient-Reported Outcomes. Inflamm Bowel Dis 2022; 28: 710–719. [Link]
40.
Fairbrass KM, Lovatt J, Barberio B, et al. Bidirectional brain–gut axis effects influence mood and prognosis in IBD: a systematic review and meta-analysis. Gut 2022; 71: 1773–1780. [Link]
41.
Cosnes J, Cattan S, Blain A, et al. Long-term evolution of disease behavior of Crohn’s disease. Inflamm Bowel Dis 2002; 8: 244–250. [Link]
42.
Pariente B, Cosnes J, Danese S, et al. Development of the Crohn’s disease digestive damage score, the Lémann score. Inflamm Bowel Dis 2011; 17: 1415–1422. [Link]
43.
Siegel CA, Sharma D, Griffith J, et al. Treatment Pathways in Patients With Crohn’s Disease and Ulcerative Colitis: Understanding the Road to Advanced Therapy. Crohns Colitis 360 2024; 6: otae040. [Link]
44.
Lim W-C, Wang Y, MacDonald JK, et al. Aminosalicylates for induction of remission or response in Crohn’s disease. Cochrane Database Syst Rev 2016; 7: CD008870. [Link]
45.
Lamb CA, Kennedy NA, Raine T, et al. British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut 2019; 68: S1-106. [Link]
46.
Al Sulais E, Louis E, Bokemeyer B, et al. Differences in the Adverse Event Burden of Corticosteroid Use in Inflammatory Bowel Disease as Reported Between Adverse Event Reporting Systems and a Patient Questionnaire. J Crohns Colitis 2025; 19: jjae138. [Link]
47.
Lichtenstein GR, Feagan BG, Cohen RD, et al. Serious infection and mortality in patients with crohn’s disease: More than 5 years of follow-up in the TREAT registry. Am J Gastroenterol 2012; 107: 1409–1422. [Link]
48.
Blackwell J, Selinger C, Raine T, et al. Steroid use and misuse: a key performance indicator in the management of IBD. Frontline Gastroenterol 2021; 12: 207–213. [Link]
49.
Noor NM, Sousa P, Paul S, et al. Early Diagnosis, Early Stratification, and Early Intervention to Deliver Precision Medicine in IBD. Inflamm Bowel Dis 2022; 28: 1254–1264. [Link]
50.
D’Haens G, Baert F, van Assche G, et al. Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn’s disease: an open randomised trial. Lancet 2008; 371: 660–667. [Link]
51.
Colombel JF, Panaccione R, Bossuyt P, et al. Effect of tight control management on Crohn’s disease (CALM): a multicentre, randomised, controlled phase 3 trial. Lancet 2017; 390: 2779–2789. [Link]
52.
Revés J, Fernandez-Clotet A, Ordás I, et al. Early Biological Therapy Within 12 Months of Diagnosis Leads to Higher Transmural Healing Rates in Crohn’s Disease. Clin Gastroenterol Hepatol 2025; 23: 1194-1203e2. [Link]
53.
Noor NM, Lee JC, Bond S, et al. A biomarker-stratified comparison of top-down versus accelerated step-up treatment strategies for patients with newly diagnosed Crohn’s disease (PROFILE): a multicentre, open-label randomised controlled trial. Lancet Gastroenterol Hepatol 2024; 9: 415–427. [Link]
54.
Ahuja D, Luo J, Qi Y, et al. Impact of Treatment Response on Risk of Serious Infections in Patients With Crohn’s Disease: Secondary Analysis of the PYRAMID Registry. Clin Gastroenterol Hepatol 2024; 22: 1286-1294. [Link]
55.
Jongsma MME, Aardoom MA, Cozijnsen MA, et al. First-line treatment with infliximab versus conventional treatment in children with newly diagnosed moderate-to-severe Crohn’s disease: An open-label multicentre randomised controlled trial. Gut 2022; 71: 34–42. [Link]
56.
Adler J, Gadepalli S, Rahman M, et al. Early tumour necrosis factor antagonist treatment prevents perianal fistula development in children with Crohn’s disease: post hoc analysis of the RISK study. Gut 2025; 74: 539-546. [Link]
57.
Noor NM, Bourke A, Subramanian S. Review article: Novel therapies in inflammatory bowel disease – An update for clinicians. Aliment Pharmacol Ther 2024; 60: 1244–1260. [Link]
58.
Ponsioen CY, de Groof EJ, Eshuis EJ, et al. Laparoscopic ileocaecal resection versus infliximab for terminal ileitis in Crohn’s disease: a randomised controlled, open-label, multicentre trial. Lancet Gastroenterol Hepatol 2017; 2: 785–792. [Link]
59.
Agrawal M, Ebert AC, Poulsen G, et al. Early Ileocecal Resection for Crohn’s Disease Is Associated With Improved Long-term Outcomes Compared With Anti-Tumor Necrosis Factor Therapy: A Population-Based Cohort Study. Gastroenterology 2023; 165: 976-985.e3. [Link]
60.
Grellier N, Kirchgesner J, Uzzan M, et al. Early ileal resection in Crohn’s disease is not associated with severe long‐term outcomes: The ERIC study. Aliment Pharmacol Ther 2024; 60: 1388–1397. [Link]
61.
Adamina M, Minozzi S, Warusavitarne J, et al. ECCO Guidelines on Therapeutics in Crohn’s Disease: Surgical Treatment. J Crohns Colitis 2024; 18: 1556-1582. [Link]
62.
Zaman S, Mohamedahmed AYY, Abdelrahman W, et al. Minimally Invasive Surgery for Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis of Robotic Versus Laparoscopic Surgical Techniques. J Crohns Colitis 2024; 18: 1342–1355. [Link]
63.
Buskens CJ, Bemelman WA. The surgeon and inflammatory bowel disease. British Journal of Surgery 2019; 106: 1118–1119. [Link]
64.
D’Amico F, Gomollón F, Bamias G, et al. Proportion of inflammatory bowel diseases patients with suboptimal disease control in daily clinical practice—Real‐world evidence from the inflammatory bowel diseases‐podcast study. United European Gastroenterol J 2024; 12: 705–716. [Link]
65.
De Cruz P, Kamm MA, Hamilton AL, et al. Crohn’s disease management after intestinal resection: a randomised trial. The Lancet 2015; 385: 1406–1417. [Link]
66.
Turner D, Ricciuto A, Lewis A, et al. STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD. Gastroenterology 2021; 160: 1570–1583. [Link]
67.
Wilkens R, Dolinger M, Burisch J, et al. Point-of-Care Testing and Home Testing: Pragmatic Considerations for Widespread Incorporation of Stool Tests, Serum Tests, and Intestinal Ultrasound. Gastroenterology 2022; 162: 1476–1479. [Link]
68.
Ernest-Suárez K, Noor NM. Not All Transmural Healing is Equal in Crohn’s Disease: Magnetic Resonance Enterography and Intestinal Ultrasound for Stricture Assessment in the STRIDENT Trial. Inflamm Bowel Dis 2025; 31: 2318-2320. [Link]
69.
Sharip MT, Brezina B, De La Revilla Negro J, et al. A Treat-to-Target Approach in IBD: Contemporary Real-World Perspectives from an International Survey. J Clin Med 2025; 14: 667. [Link]
70.
Singh S, Nguyen JD, Fudman DI, et al. Treat-to-target of endoscopic remission in patients with inflammatory bowel disease in symptomatic remission on advanced therapies (QUOTIENT): rationale, design and protocol for an open-label, multicentre, pragmatic, randomised controlled trial. BMJ Open Gastroenterol 2025; 12: e001615. [Link]

Abstract

Pancreatic exocrine insufficiency (PEI) is a common yet frequently under-recognised cause of maldigestion, malabsorption, and malnutrition. Although traditionally associated with primary pancreatic disorders such as chronic pancreatitis, cystic fibrosis, pancreatic cancer, or pancreatic surgery, it is now evident that PEI also occurs in a wide range of extra-pancreatic conditions and clinical settings. Advances in diagnostic testing and expanding clinical awareness have improved detection; however, significant misconceptions persist regarding when to suspect PEI; how to interpret diagnostic tests; and how to initiate, optimise, and monitor pancreatic enzyme replacement therapy (PERT). In everyday practice, these errors may lead to delayed diagnosis, inappropriate treatment, persistent symptoms, and preventable nutritional deficiencies. This “Mistakes in…” article highlights common pitfalls in the diagnosis and management of PEI, focusing on inappropriate reliance on faecal elastase testing, failure to recognise secondary causes, undertreatment with PERT, and inadequate nutritional assessment. By addressing these frequent mistakes, we aim to promote a more structured, patient-centred, and evidence-informed approach to PEI that improves clinical outcomes and quality of life.

Topics

Pancreas

Published

2026

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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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References

Mistakes
References
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60.
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61.
Adamina M, Minozzi S, Warusavitarne J, et al. ECCO Guidelines on Therapeutics in Crohn’s Disease: Surgical Treatment. J Crohns Colitis 2024; 18: 1556-1582. [Link]
62.
Zaman S, Mohamedahmed AYY, Abdelrahman W, et al. Minimally Invasive Surgery for Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis of Robotic Versus Laparoscopic Surgical Techniques. J Crohns Colitis 2024; 18: 1342–1355. [Link]
63.
Buskens CJ, Bemelman WA. The surgeon and inflammatory bowel disease. British Journal of Surgery 2019; 106: 1118–1119. [Link]
64.
D’Amico F, Gomollón F, Bamias G, et al. Proportion of inflammatory bowel diseases patients with suboptimal disease control in daily clinical practice—Real‐world evidence from the inflammatory bowel diseases‐podcast study. United European Gastroenterol J 2024; 12: 705–716. [Link]
65.
De Cruz P, Kamm MA, Hamilton AL, et al. Crohn’s disease management after intestinal resection: a randomised trial. The Lancet 2015; 385: 1406–1417. [Link]
66.
Turner D, Ricciuto A, Lewis A, et al. STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD. Gastroenterology 2021; 160: 1570–1583. [Link]
67.
Wilkens R, Dolinger M, Burisch J, et al. Point-of-Care Testing and Home Testing: Pragmatic Considerations for Widespread Incorporation of Stool Tests, Serum Tests, and Intestinal Ultrasound. Gastroenterology 2022; 162: 1476–1479. [Link]
68.
Ernest-Suárez K, Noor NM. Not All Transmural Healing is Equal in Crohn’s Disease: Magnetic Resonance Enterography and Intestinal Ultrasound for Stricture Assessment in the STRIDENT Trial. Inflamm Bowel Dis 2025; 31: 2318-2320. [Link]
69.
Sharip MT, Brezina B, De La Revilla Negro J, et al. A Treat-to-Target Approach in IBD: Contemporary Real-World Perspectives from an International Survey. J Clin Med 2025; 14: 667. [Link]
70.
Singh S, Nguyen JD, Fudman DI, et al. Treat-to-target of endoscopic remission in patients with inflammatory bowel disease in symptomatic remission on advanced therapies (QUOTIENT): rationale, design and protocol for an open-label, multicentre, pragmatic, randomised controlled trial. BMJ Open Gastroenterol 2025; 12: e001615. [Link]

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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Episode 6: UEG Journal October Spotlight

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Maria Manuela Estevinho Maria Manuela Estevinho, Mohsan Subhani

UEG Podcast Episode
Journal Podcast
Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

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Episode 6: UEG Journal October Spotlight

Mohsan Subhani, Maria Manuela Estevinho

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

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.

Abstract

Topics

Endoscopy Hepatobiliary IBD Pancreas

Published

2025

More Like This:

Malignancy in IBD with Hannah Gordon

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Pradeep Mundre Pradeep Mundre, Hannah Gordon

Mistakes in the management of peritoneal malignancies and how to avoid them

Mistakes in the management of peritoneal malignancies and how to avoid them

Charlotte Rabl Charlotte Rabl, Tarkan Jäger, Andrea Barberis, Matteo Santoliquido, Francesco Saverio Papadia

Coeliac disease with David Sanders

Coeliac disease with David Sanders

Pradeep Mundre Pradeep Mundre, David S. Sanders

Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Matthias Löhr Matthias Löhr, J. Enrique Domínguez Muñoz, Miroslav Vujasinovic

Mistakes in abdominal distension and how to avoid them

Mistakes in abdominal distension and how to avoid them

Alberto Ezquerra-Durán Alberto Ezquerra-Durán, Elizabeth Barba Orozco

Episode 6: UEG Journal October Spotlight

Episode 6: UEG Journal October Spotlight

Maria Manuela Estevinho Maria Manuela Estevinho, Mohsan Subhani

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