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.

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 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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Gonçalo Alexandrino

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Mistakes in nutrition in chronic liver disease and how to avoid them

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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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MASLD with Sven Francque - Part 2

Sven Francque, Pradeep Mundre

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Abstract

Topics

Hepatobiliary

Published

2026

More Like This:

Mistakes in hepatitis C and how to avoid them

Gonçalo Alexandrino

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Helena Cortez-Pinto

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Pradeep Mundre

Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

Mistakes in metabolic dysfunction associated steatotic liver disease and how to avoid them

Sarah Townsend

Mistakes in nutrition in chronic liver disease and how to avoid them

Manuela Merli

UEG Mistakes In Articles

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Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

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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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Mistakes in hepatitis C and how to avoid them

Gonçalo Alexandrino

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Helena Cortez-Pinto

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Pradeep Mundre

Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

Mistakes in metabolic dysfunction associated steatotic liver disease and how to avoid them

Sarah Townsend

Mistakes in nutrition in chronic liver disease and how to avoid them

Manuela Merli

UEG Mistakes In Articles

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Mistakes in metabolic dysfunction associated steatotic liver disease and how to avoid them

Sarah Townsend, Philip Newsome

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Abstract

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is a subclassification of steatotic liver disease (SLD), defined as the presence of excess triglyceride storage in the liver in conjunction with at least one cardiometabolic risk factor and no other discernible cause.1 Cirrhosis secondary to MASH is the most common cause of liver disease in the world and is the fastest-growing indication for liver transplantation, but it also has a >50% recurrence rate post-transplantation.

Topics

Hepatobiliary

Citation

Townsend SA and Newsome PN. Mistakes in nonalcoholic fatty liver disease and how to avoid them. UEG Education 2017; 17: 39–41.

Published

2024

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Mistakes in hepatitis C and how to avoid them

Gonçalo Alexandrino

Mistakes in alcoholic liver disease and how to avoid them

Helena Cortez-Pinto

MASLD with Sven Francque - Part 2

Pradeep Mundre

Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

Mistakes in metabolic dysfunction associated steatotic liver disease and how to avoid them

Sarah Townsend

Mistakes in nutrition in chronic liver disease and how to avoid them

Manuela Merli

UEG Mistakes In Articles

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

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 nutrition in chronic liver disease and how to avoid them

Manuela Merli

Summary

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Abstract

Malnutrition frequently occurs in patients who have chronic liver disease and worsens their prognosis. There are multiple causes of malnutrition in the context of cirrhosis: low dietary intake, malabsorption, metabolic alterations and modification of substrate utilisation. Sarcopenia, which is defined by loss of muscle mass and function, is a major component of malnutrition in patients with cirrhosis. Sarcopenia adversely affects the number and severity of complications, quality of life, the outcome of liver transplantation and the overall survival rate of patients with advanced liver disease. Physicians should be aware of the clinical and prognostic relevance of nutritional status, how to promptly recognise malnutrition and sarcopenia in patients with liver cirrhosis and how to appropriately manage these conditions. Here we discuss some mistakes that are frequently made regarding nutrition in chronic liver disease, and we provide evidence and experience-based approaches to avoid them.

Topics

Hepatobiliary Small Intestine & Nutrition

Citation

Merli M and Lapenna L. Mistakes in nutrition in chronic liver disease and how to avoid them. UEG Education 2021; 21: 23–25

Published

2021

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Mistakes in hepatitis C and how to avoid them

Gonçalo Alexandrino

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Helena Cortez-Pinto

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Pradeep Mundre

Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

Mistakes in metabolic dysfunction associated steatotic liver disease and how to avoid them

Sarah Townsend

Mistakes in nutrition in chronic liver disease and how to avoid them

Manuela Merli