Mistakes in biomarkers for IBD and how to avoid them

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Mistakes in biomarkers for IBD and how to avoid them

James C. Lee, Chris Palmer-Jones

Summary

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An article reviews common mistakes in biomarker development, interpretation, and application for inflammatory bowel disease, addressing the challenge of disease heterogeneity that drives trial-and-error treatment approaches.

IBD complexity arises from heterogeneity in Crohn's disease and ulcerative colitis, leading to differences in disease course, complications, and treatment responses among patients.
Current IBD treatment strategies rely on a trial-and-error approach, creating a need for personalized therapy.
Efforts have been made to develop reliable prognostic and predictive biomarkers to overcome disease heterogeneity.
The article discusses common mistakes in biomarker work and draws on evidence-based insights and lessons from other fields.
Clinicians and researchers focused on IBD biomarker development or personalized treatment strategies would benefit from this material.

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Abstract

The complexity of managing inflammatory bowel disease (IBD) stems from the heterogeneity of Crohn’s disease and ulcerative colitis. This leads to differences in disease course, complications, and treatment responses among patients. Current treatment strategies rely on a trial-and-error approach, but there's a need for personalized therapy. Efforts have been made to develop reliable prognostic and predictive biomarkers to overcome disease heterogeneity. This article discusses common mistakes in biomarker development, interpretation, and application in IBD, emphasizing evidence-based insights and lessons learned from other fields.

Topics

IBD

Citation

Palmer-Jones C. and Lee J. C. Mistakes in biomarkers for IBD and how to avoid them. UEG Education 2023; 23: 8-11.

Published

2023

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UEG Mistakes In Articles

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

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

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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

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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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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 Podcast Episode

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Coeliac disease with David Sanders

David S. Sanders, Pradeep Mundre

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Abstract

Topics

Small Intestine & Nutrition

Published

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MASLD with Sven Francque - Part 2

Sven Francque, Pradeep Mundre

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Abstract

Topics

Hepatobiliary

Published

2026

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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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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

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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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