Inflammatory Bowel Disease

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Quick Reference

RxDrug of choiceInfliximab (UC/CD), EEN (Pediatric CD induction)

AltAlternativesUstekinumab, Vedolizumab, Upadacitinib, Filgotinib

⊘AvoidLive vaccines while on biologics; NSAIDs (may trigger flares)

DxTest of choiceColonoscopy with biopsy (Diagnosis); IUS/MRE (Monitoring)

ScKey scoreMontreal Classification (Adults); PUCAI/wPCDAI (Pediatric)

→When to referAcute severe colitis, suspected stricture/obstruction, perianal fistulas, growth failure, or failure of first-line biologics

IBD is a systemic inflammatory disease requiring a treat-to-target approach focused on transmural healing via biologics, small molecules, or nutritional induction.

Inflammatory Bowel Disease (IBD) is a chronic, relapsing, immune-mediated systemic disorder characterized by persistent gastrointestinal inflammation and cyclical tissue damage. It primarily encompasses two distinct clinical entities: [[Crohn's disease]] (CD), which features transmural inflammation and can involve any segment of the GI tract, and [[ulcerative colitis]] (UC), which is limited to continuous mucosal inflammation of the colon and rectum. The global prevalence is rising, particularly in newly industrialized nations, and the disease now affects a significant number of older adults.

Overview and Recommendations

Background

•Recognize IBD as a heterogeneous group of idiopathic inflammatory conditions, primarily and , driven by a complex interplay of genetic susceptibility, environmental triggers, and dysregulated immune responses. While CD is characterized by 'skip lesions' and transmural involvement, UC typically presents with continuous mucosal inflammation starting from the rectum.
•Identify the global epidemiological shift where IBD prevalence is increasing worldwide, now affecting over 5 million individuals with UC alone. While traditionally a disease of young adults, the 'elderly-onset' population (≥60 years) is the fastest-growing demographic, presenting unique challenges due to comorbidities and increased frailty.
•Understand the systemic nature of IBD, which extends beyond the gut to include extraintestinal manifestations (EIMs) such as , uveitis, and primary sclerosing cholangitis. IBD is also associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD) and venous thromboembolism (VTE), particularly during active flares.
•Note the importance of phenotypic variants such as perianal fistulizing Crohn's disease (pfCD) and acute severe ulcerative colitis (ASUC). ASUC is a life-threatening emergency requiring rapid hospitalization and intensive medical rescue to avoid emergency colectomy.
•Consider the role of genetic drivers like the NOD2 gene, which is found in approximately 40% of Caucasian CD patients and is linked to related multisystem disorders such as Yao syndrome (YAOS) and Blau syndrome.

Evaluation

•Suspect IBD in patients presenting with chronic diarrhea (especially nocturnal), hematochezia, abdominal pain, weight loss, or unexplained growth failure in pediatric populations. Always ask about a family history of IBD and the presence of extraintestinal symptoms like joint pain or skin rashes.
•Obtain baseline inflammatory biomarkers, specifically C-reactive protein (CRP) and fecal calprotectin. Fecal calprotectin is highly sensitive for intestinal inflammation and is used to differentiate IBD from functional disorders like (IBS).
•Order a complete blood count (CBC) and iron studies to screen for anemia, which is the most common systemic complication. Also, check albumin levels as hypoalbuminemia can indicate severe disease and predict poor response to certain biologics like infliximab.
•Perform a thorough physical examination, including a digital rectal exam and inspection of the perianal area for skin tags, fistulas, or abscesses, which are highly suggestive of Crohn's disease.
•Utilize (IUS) as a first-line, non-invasive tool to assess bowel wall thickness (BWT). A BWT > 3 mm is a key indicator of active inflammation and can be used for longitudinal monitoring without radiation exposure.
•Order Magnetic Resonance Enterography (MRE) or CT Enterography (CTE) to evaluate for small bowel involvement, strictures, or penetrating disease (fistulas/abscesses) that cannot be reached by standard endoscopy.
•Perform a with multiple biopsies from both inflamed and non-inflamed segments. Histological features such as crypt abscesses in UC or non-caseating granulomas in CD are diagnostic hallmarks.
•Classify the disease using the Montreal Classification for adults or the Paris Classification for pediatric patients to standardize the description of disease location, behavior, and age at onset.
•Rule out infectious mimics, particularly Clostridioides difficile, which has a high prevalence (up to 28%) in IBD patients on biologics and can trigger or exacerbate flares.
•Screen for baseline sarcopenia and nutritional deficiencies using EWGSOP2 criteria, as muscle loss is a significant predictor of poor outcomes and incident IBD.
•Evaluate for perianal disease using pelvic MRI, which is the reference standard for classifying complex branching fistulas, or transperineal ultrasonography (TPUS) as a non-invasive alternative.
•Assess for psychological comorbidities, including anxiety and depression, which are highly prevalent and closely correlated with disease activity, especially in adolescents.

Management

•Adopt a 'treat-to-target' strategy aiming for transmural healing (TMH), defined by the normalization of bowel wall thickness on ultrasound, rather than just symptomatic relief. TMH is associated with superior long-term outcomes and lower surgery rates.
•Induce remission in moderate-to-severe UC using Guselkumab 200 mg or 400 mg IV at weeks 0, 4, and 8, or initiate anti-TNF therapy such as Infliximab 5 mg/kg IV.
•Manage Acute Severe Ulcerative Colitis (ASUC) with inpatient IV Methylprednisolone 60 mg/day. If no response is seen by day 3 (e.g., PUCAI score > 45 in children), initiate rescue therapy with Infliximab 5 mg/kg or Cyclosporine.
•Utilize personalized dosing models (e.g., iDose) for Infliximab in ASUC to account for high drug clearance in patients with high inflammatory burdens, aiming to maximize colectomy-free survival.
•Administer Exclusive Enteral Nutrition (EEN) as first-line induction therapy for pediatric Crohn's disease. Provide 100% of daily caloric requirements via liquid formula for 6 to 8 weeks to induce mucosal healing and avoid steroid toxicity.
•Transition to maintenance therapy with Subcutaneous (SC) Infliximab 120 mg every 2 weeks, which often achieves higher colonic tissue concentrations than IV administration.
•Consider Ustekinumab for Crohn's disease, induced with a weight-tiered IV dose (e.g., 6 mg/kg for patients ≥40 kg) and maintained with 90 mg SC every 8 weeks, especially in patients with symptomatic ileal strictures.
•Employ small molecule JAK inhibitors like Upadacitinib 15-30 mg daily or Filgotinib 200 mg daily for refractory UC cases that have failed biologic therapy.
•Monitor therapy using Therapeutic Drug Monitoring (TDM) to assess drug trough levels and the development of anti-drug antibodies (ADAs), particularly when clinical response is lost.
•Address iron deficiency anemia with IV Iron (e.g., Ferric Carboxymaltose 1000 mg) rather than oral iron during active flares to ensure better absorption and avoid GI irritation.
•Implement bone protection for patients on prolonged corticosteroids, including Calcium 1000–1200 mg/day and Vitamin D 800–1000 IU/day, to mitigate the risk of osteoporosis and fractures.
•Refer for surgical consultation early in cases of uncomplicated ileocaecal CD; laparoscopic ileocaecal resection is a valid alternative to Infliximab with high rates of long-term therapy-free remission.
•Manage fibrostenotic strictures with Endoscopic Balloon Dilation (EBD) or Endoscopic Stricturotomy (ESt) for short (< 5 cm) accessible lesions before considering surgical resection.
•Maintain maintenance therapy throughout pregnancy to prevent flares, as active disease is the greatest risk to the fetus. Anti-TNFs, Vedolizumab, and Ustekinumab are generally considered safe during gestation.
•Avoid live vaccines in patients on biologics or immunosuppressants. Ensure all age-appropriate vaccinations and screenings (e.g., TB, Hepatitis B/C) are completed prior to starting advanced therapies.

Board Review — High Yield

•ASCA vs pANCA — Anti-Saccharomyces cerevisiae antibodies (ASCA) are associated with Crohn's; pANCA is more common in Ulcerative Colitis.
•Transmural vs Mucosal — Crohn's involves the full thickness of the bowel wall (transmural); UC is limited to the mucosa and submucosa.
•Skip Lesions — Characteristic of Crohn's disease, where areas of inflammation are separated by normal-appearing mucosa.
•Crypt Abscesses — A classic histological finding in Ulcerative Colitis representing neutrophils within the colonic crypts.
•Toxic Megacolon — A surgical emergency defined by colonic dilation > 6 cm associated with systemic toxicity.
•Exclusive Enteral Nutrition (EEN) — The preferred first-line induction therapy for pediatric Crohn's disease, superior to steroids for mucosal healing.
•Rutgeerts Score — Used to assess the risk of endoscopic recurrence in Crohn's disease after ileocaecal resection.
•NOD2/CARD15 — The first gene associated with Crohn's disease susceptibility, particularly ileal involvement.

Deep Dive — Evidence Details

Epidemiology and Risk Factors

▸UC incidence is increasing in Asia, and paediatric-onset IBD remains a major treatment and healthcare-planning subgroup. [122,124,126]
▸Risk assessment should account for geography, respiratory disease, prenatal medication exposure, metabolic syndrome, anemia, frailty, cancer, and endemic infections. [117,127-129,132,133,135]
▸Postoperative complications in CD surgery occur in approximately **20%–50%** of reported cases. [118]
▸Frailty is defined as **≥3** Fried-derived criteria in the cited cohort. [135]
▸Advanced therapies may reduce paediatric resection rates but can be associated with infection, psychiatric, and immunogenicity risks. [123,124,126,130]

CP Clinical Pearl: Epidemiological risk assessment in IBD should be multidimensional: consider age at onset, geography, respiratory and cardiometabolic comorbidity, nutritional phenotype, cancer history, endemic infections, and treatment exposure. [117,127-129,132,133,135]

! Warning: Most cited associations are observational or derived from selected cohorts; they identify risk signals but do not by themselves establish causality or support universal treatment changes. [117,123,126-130,132,133]

Global and temporal epidemiology

Inflammatory bowel disease (IBD) comprises Crohn disease (CD) and ulcerative colitis (UC), both chronic inflammatory disorders whose epidemiology varies by age, geography, and calendar period. Recent evidence indicates that UC incidence is increasing in Asia; a Korean multicentre inception cohort enrolled 353 patients with newly diagnosed moderate-to-severe UC between 2014 and 2017 and followed them for a median of 4.9 years. ^[122]^C The available references do not provide a pooled global prevalence or incidence estimate, but they document IBD across Europe, the Middle East, East Asia, and the United Kingdom, supporting its worldwide distribution. ^[123]^[124]^[126]^[128]^[129]^[133]^C

Paediatric-onset disease is an important epidemiological subgroup. A UK population-based cohort included children aged ≤17 years diagnosed with IBD between 2007 and 2024 and evaluated changing anti-TNF exposure and abdominal surgery rates over an 18-year period. ^[124] A nationwide US claims study evaluated children and adolescents aged 6–17 years who newly initiated infliximab or adalimumab, illustrating the substantial paediatric population requiring advanced therapy. ^[126] Pediatric treatment patterns are also evolving, with systematic-review evidence addressing combined biologic and/or small-molecule therapy in children through January 2026. ^[119]

Demographic and geographic factors

Disease burden and treatment-related outcomes differ across populations. In a Middle Eastern cohort from the United Arab Emirates, anti-TNF immunogenicity was evaluated across 314 treatment courses in 248 patients, comprising infliximab and adalimumab exposure. ^[123] The study highlights the importance of regional data because immunogenicity rates and drug-level thresholds may vary according to population and clinical context. ^[123] A Spanish population-based study from the Valencian Community examined symptomatic leishmaniasis among patients with IBD receiving biologic therapy in a Mediterranean endemic region, emphasizing that local infectious exposures modify risk in immunosuppressed populations. ^[133]^C

Age is also relevant to comorbidity. A Danish nationwide cohort included 53,591 patients with IBD and 267,955 age- and sex-matched controls to assess interstitial lung disease (ILD), while a separate Danish study included 59,494 patients with IBD, of whom 20,551 had CD and 38,943 had UC, to evaluate IBD management in the setting of cancer. ^[128]^[132] These studies reflect the growing clinical importance of multimorbidity as IBD populations age. ^[128]^[132]

Environmental and early-life risk factors

Prenatal exposure to acid-suppressive medication has been investigated as a potential early-life risk factor. A nationwide South Korean mother–child cohort assessed proton-pump inhibitor and H2-receptor antagonist exposure during pregnancy and subsequent incident IBD, including CD and UC, in offspring followed through 2023. ^[129] Because the cited study is observational, any association should not be interpreted as proof of causation, and confounding by maternal illness or healthcare utilisation remains relevant. ^[129]

Respiratory disease may share epidemiological or biological links with IBD. A systematic review and meta-analysis of observational studies evaluated the bidirectional association between IBD and obstructive lung diseases, including chronic obstructive pulmonary disease, asthma, and bronchiectasis. ^[117] A Danish nationwide cohort additionally assessed incident ILD and mortality among patients with IBD. ^[128] Together, these studies support consideration of chronic respiratory disease as an important associated condition, although the references do not establish a single causal pathway. ^[117]^[128]

Comorbidity and disease-related risk factors

Metabolic syndrome (MetS) is an increasingly relevant comorbidity. A real-world cohort of adults with CD or UC followed from 2010 to 2024 evaluated temporal trends in cardiometabolic disease and compared outcomes among patients with IBD and MetS, IBD without MetS, and MetS without IBD. ^[127] The study specifically examined cardiovascular, hepatic, renal, and IBD-related outcomes, indicating that cardiometabolic risk should be incorporated into long-term assessment. ^[127]

Anemia is particularly frequent in CD compared with UC. A systematic review identified chronic inflammation, impaired iron absorption, intestinal blood loss, and microbiome-related mechanisms as contributors; CD-associated dysbiosis may include increased siderophore-producing Enterobacteriaceae that compete with host iron acquisition. ^[120] Frailty is another clinically important phenotype. In a prospective single-centre cohort of adults hospitalised with active IBD who required biologic or small-molecule initiation, frailty was defined using a modified Fried index, with ≥3 criteria indicating frailty and 1–2 criteria indicating an intermediate state. ^[135]^C

Risk factors for adverse outcomes

In CD surgery, postoperative complication rates are reported at approximately 20%–50%, including surgical-site infection, intra-abdominal abscess, and anastomotic leakage. ^[118] A systematic review identified clinical and perioperative predictors and evaluated predictive biomarkers, although accurate individual risk stratification remains difficult. ^[118] Postoperative endoscopic recurrence after ileocolic resection may also be influenced by retained mesenteric tissue: a multicentre study examined residual ileocolic artery length as a surrogate for residual mesenteric burden. ^[125]

Treatment exposure modifies risk but may also reduce disease complications. An 18-year paediatric cohort associated increasing anti-TNF use with reductions in abdominal resection rates, although this was observational evidence. ^[124] Conversely, advanced therapy was associated with higher risks of tuberculosis and depression/anxiety than conventional therapy in a 13-hospital common-data-model analysis, with reported hazard ratios of 2.86 and 1.58, respectively. ^[130] In children, comparative infection risk between infliximab and adalimumab was assessed using nationwide claims data, but the cited abstract does not provide the effect estimate. ^[126] Anti-TNF immunogenicity occurred in 28.3% (89/314) of treatment courses in the Middle Eastern cohort and was evaluated as a contributor to loss of response. ^[123]

Finally, IBD patients with prior or coexisting cancer represent a growing subgroup requiring individualised treatment and surgical-risk assessment. ^[132] Rare intestinal ulceration with pancytopenia and concurrent myelodysplastic syndrome or aplastic anaemia has been associated with high mortality in pooled case-based evidence, although this represents an uncommon, highly selected complication rather than a population-level risk factor. ^[121]

Selected epidemiological and risk-associated findings

Domain	Evidence	Reference
Asian epidemiology	Increasing UC incidence reported in Asia; Korean cohort of 353 newly diagnosed moderate-to-severe patients	^[122]^C
Paediatric IBD	UK cohort included patients aged ≤17 years over 2007–2024; US claims cohort included ages 6–17 years	^[124]^[126]
Anti-TNF immunogenicity	28.3% (89/314) of treatment courses in a Middle Eastern cohort	^[123]
CD surgical morbidity	Reported postoperative complication rates of 20%–50%	^[118]
Frailty	≥3 modified Fried criteria classified patients as frail	^[135]^C
Advanced-therapy risks	Tuberculosis HR 2.86; depression/anxiety HR 1.58 versus conventional therapy	^[130]

Supportive Care and Complication Management

▸EEN is an established pediatric induction strategy, and adult evidence suggests a pooled real-world clinical-remission rate of 66%, although adult evidence is heterogeneous. [140,144]
▸CDED with or without PEN and modified Mediterranean diet strategies may support nutritional and postoperative care, but comparative evidence remains limited. [136-138,145]
▸Anemia and fatigue require assessment of inflammation, iron availability, blood loss, nutrition, sleep, and psychological health. [120,149]
▸Urgent multidisciplinary assessment is warranted for intestinal ulceration with pancytopenia because this rare presentation has high reported mortality. [121]
▸Stricture classification should integrate cross-sectional imaging, endoscopic findings, symptoms, and—when available—histopathology; **≥2.5 cm** prestenotic dilatation is the revised CT-enterography threshold discussed in the cited evidence. [142,147,148]
▸Perianal abscess in children warrants drainage and follow-up for later CD diagnosis, particularly when anemia or hypoalbuminemia is present. [67]
▸Advanced-therapy monitoring should include tuberculosis risk and mental-health assessment. [130]

Dx Diagnostic Essentials: In a patient with suspected Crohn-related stricture, determine whether disease is inflammatory, fibrotic, or mixed before selecting medical, endoscopic, or surgical management. [142,146-148]

! Warning: Intestinal ulceration accompanied by pancytopenia is a rare, high-risk presentation associated with myelodysplastic syndrome or aplastic anemia and requires urgent specialist evaluation. [121]

HY High Yield: At CT enterography, the cited revised criterion defines small-bowel stricture using **≥2.5 cm** prestenotic dilatation; the **2.5–3 cm** subgroup should not automatically be treated as equivalent to dilation **>3 cm** for risk assessment. [147]

Nutritional support and dietary therapy

Nutritional assessment and individualized dietary counseling are important components of Crohn’s disease (CD) care, particularly in children and after intestinal surgery. Exclusive enteral nutrition (EEN) is an established induction option for pediatric active CD, and a 2026 comparative analysis evaluated EEN against corticosteroids in children with newly diagnosed ileal small-bowel disease, with sustained steroid-free remission at 1 year, growth, biologic initiation, and intestinal resection as key outcomes. ^[140] EEN has also been evaluated in adults; a systematic review of 40 studies involving 2,459 adults reported a pooled clinical-remission rate of 66% in 23 real-world cohorts, although the evidence included both randomized and nonrandomized studies. ^[144]

The Crohn’s Disease Exclusion Diet (CDED) has been studied with either partial enteral nutrition (PEN) or EEN in children. In a prospective randomized cohort of 54 children, both regimens were associated with longitudinal assessment of the oral microbiome over 52 weeks, and no significant difference in primary or clinical outcomes between treatment groups was reported in the available abstract; COVID-19-related disruption affected sampling. ^[136] A separate randomized pediatric trial directly compared CDED alone with CDED plus PEN in children aged 4–18 years with mild-to-moderate CD, addressing whether PEN adds benefit to the exclusion diet. ^[137] These findings support shared decision-making regarding dietary induction and the need for monitoring of disease activity, nutritional adequacy, growth, and treatment tolerability rather than assuming that one nutritional regimen is universally superior. ^[136]^[137]

A modified Mediterranean diet supplemented with PEN was evaluated for 4–5 weeks against EEN in a pilot randomized trial of post-surgical patients with CD, with quality of life measured using the IBDQOL-22 as the primary outcome and nutritional status and disease-related characteristics as secondary outcomes. ^[138]^C A systematic review and meta-analysis of Mediterranean-diet interventions in IBD included eight studies; seven studies involving 223 participants contributed data on induction of remission, indicating that this approach remains an evidence-generating rather than definitive replacement for disease-directed therapy. ^[145]

Anemia, fatigue, and hematologic complications

Anemia is a frequent systemic complication of IBD and is reported more often in CD than in ulcerative colitis (UC). Proposed mechanisms include chronic inflammation, impaired iron absorption, intestinal blood loss, and microbiome-related effects on host iron availability; CD-associated dysbiosis may include increased siderophore-producing Enterobacteriaceae that compete for iron. ^[120] Evaluation should therefore be integrated with assessment of inflammatory activity, intestinal blood loss, nutritional status, and other causes of anemia, although the cited systematic review does not establish a specific replacement regimen. ^[120]

Fatigue can remain clinically important in patients with CD receiving pharmacological treatment. An observational study evaluated inflammatory bowel disease fatigue scores, visual-analog fatigue measures, depression, anxiety, stress, insomnia, and laboratory variables to identify psychological and hematologic factors associated with fatigue. ^[149] Management should consequently address potentially modifiable contributors, including active inflammation, anemia or other laboratory abnormalities, sleep disturbance, and psychological symptoms, while recognizing that the study was observational and did not establish treatment efficacy. ^[149]

Rarely, intestinal ulceration with pancytopenia may occur in association with IBD or intestinal Behçet’s disease and concurrent myelodysplastic syndrome or aplastic anemia. A pooled individual-patient systematic review characterized this presentation as uncommon and associated with high mortality, supporting urgent multidisciplinary evaluation when ulceration and pancytopenia coexist. ^[121]

Strictures, obstruction, and perianal disease

Stricture management requires distinction between predominantly inflammatory and predominantly fibrotic disease because inflammatory strictures may respond to anti-inflammatory treatment, whereas noninflammatory strictures may require endoscopic balloon dilation or surgery. ^[142]^C Prospective MRI work evaluated T2* and diffusion-weighted intravoxel incoherent motion parameters against histopathology to distinguish inflammatory from noninflammatory strictures. ^[142]^C A collagen-binding probe PET/MR study similarly assessed noninvasive detection of bowel collagen deposition and differentiation of inflammatory, fibrotic, or mixed strictures. ^[148]^C

At CT enterography, a revised criterion uses ≥2.5 cm prestenotic dilatation as the threshold for identifying a small-bowel stricture, rather than the former >3 cm threshold. ^[147] The revised threshold increases the number of patients classified as having strictures, while the study specifically examined whether the 2.5–3 cm and >3 cm categories stratify adverse-outcome risk. ^[147] Endoscopic balloon dilation, stent placement, and endoscopic stricturotomy have all been evaluated for Crohn-related lower-gastrointestinal strictures; an indirect meta-analysis of 39 studies compared technical and clinical success, adverse events, repeat procedures, and surgery across these approaches. ^[146]

Ustekinumab has also been studied in symptomatic, imaging-confirmed ileal stricturing CD in an international multicenter retrospective cohort. Outcomes included endoscopic balloon dilation, surgery, the composite need for either intervention, recurrent obstructive symptoms, and treatment persistence; because the study was observational, results should be interpreted as cohort evidence rather than proof of antifibrotic efficacy. ^[56]

Perianal abscess requires appropriate surgical assessment and drainage. In a retrospective cohort of 204 children aged 3–18 years who underwent surgical drainage, investigators evaluated subsequent CD diagnosis and associated clinical, laboratory, and surgical factors; patients with established IBD or a clinically recognized fistula at presentation were excluded. ^[67]^D Anemia and hypoalbuminemia were specifically assessed, with hypoalbuminemia defined as serum albumin <3.5 g/dL. ^[67]^D

Safety monitoring and treatment-related complications

Advanced therapies require ongoing safety surveillance. In a 13-hospital common-data-model analysis, patients with IBD receiving advanced therapy had higher observed risks of tuberculosis and depression or anxiety than propensity-matched patients not receiving advanced therapy; the reported hazard ratios were 2.86 for tuberculosis and 1.58 for depression/anxiety. ^[130] These findings support risk-based infection assessment and attention to mental health during treatment, while recognizing that the study was retrospective and observational. ^[130]

For UC, a 2026 meta-analysis evaluated the efficacy and safety of etrasimod, an oral sphingosine-1-phosphate receptor modulator that reduces lymphocyte migration. ^[143] Its findings inform treatment decisions in moderate-to-severe UC but do not replace individualized assessment of comorbidity, infection risk, adverse effects, and alternative therapies. ^[143]

Esophageal CD is rare and presents with nonspecific symptoms that may delay diagnosis. A systematic review of 90 studies involving 100 adults described diagnostic pathways and treatment approaches, with ileocolonic disease reported as the most common primary location at 31%. ^[139] Persistent dysphagia, odynophagia, or upper-gastrointestinal symptoms in a patient with CD should therefore prompt targeted evaluation rather than being attributed automatically to reflux or medication effects. ^[139]

Complication-focused supportive care

Clinical issue	Evidence-supported management focus
Nutritional compromise or induction	Consider EEN, CDED-based strategies, PEN, or selected Mediterranean-style approaches with monitoring of remission, growth, nutritional adequacy, and tolerability. [136-145]
Anemia	Evaluate inflammation, iron availability, intestinal blood loss, malabsorption, nutrition, and possible microbiome-related iron competition. ^[120]
Fatigue	Assess disease activity, hematologic abnormalities, insomnia, depression, anxiety, and stress. ^[149]
Intestinal ulceration plus pancytopenia	Arrange urgent multidisciplinary hematologic and gastroenterologic evaluation because of the reported high mortality. ^[121]
Suspected stricture	Characterize inflammatory versus fibrotic or mixed disease using cross-sectional imaging and, when available, histopathology; consider dilation or surgery for appropriate noninflammatory disease. [142,146-148]
Perianal abscess in a child	Drain surgically when indicated and maintain follow-up for subsequent CD diagnosis; assess anemia and albumin. ^[67]^D
Advanced therapy	Monitor for tuberculosis and depression/anxiety and individualize safety surveillance. ^[130]

Special Populations

▸Preconception and pregnancy care should prioritize objective disease control and coordinated individualized management. [150][151][152][153][154][155]
▸In CD, disease activity and ileal disease—not previous abdominal surgery—were associated with preterm birth in a prospective cohort. [156]
▸Pregnancy safety evidence is strongest for anti-TNF therapy; evidence for vedolizumab, ustekinumab, and JAK inhibitors is less mature. [22]
▸Vedolizumab pregnancy data include a prospective registry of 275 pregnancies and updated systematic-review evidence. [102][158]
▸Paediatric UC with acute severe colitis requires proactive monitoring and timely medical or surgical escalation. [98]

HY High Yield: Active IBD is a more important pregnancy risk signal than a history of abdominal surgery alone; preconception disease assessment and sustained control are key. [150][151][152][153][154][155][156]

! Warning: Do not infer class-specific pregnancy risks or causal effects from the supplied abstracts when outcome estimates are incomplete, particularly for newer therapies, passive smoking, and prenatal acid-suppressive exposure. [22][99][129]

Pregnancy and preconception

Pregnancy in inflammatory bowel disease (IBD) requires coordinated, individualized care because disease activity, medication concerns, limited pregnancy-specific evidence, and inconsistent clinical practice can affect conception, adherence, and maternal–fetal outcomes. The 2025–2026 Global Consensus Statement was developed by 39 IBD and content experts and 7 patient advocates from 6 continents to address these knowledge and practice gaps. ^[150]^[151]^[152]^[153]^[154]^[155] Preconception counselling should therefore include assessment of disease activity, current and previous therapies, nutritional status, pregnancy intentions, and obstetric and surgical history, with treatment decisions balancing the risks of uncontrolled IBD against medication exposure. ^[150]^[151]^[152]^[153]^[154]^[155]

Disease control is a central determinant of pregnancy outcome. In a prospective cohort of 1,046 women with Crohn’s disease (CD), previous CD-related surgery was not associated with adverse pregnancy, delivery, or neonatal outcomes after adjustment; increased disease activity and ileal disease were associated with preterm birth, with odds ratios of 1.14 (95% CI 1.06–1.22) and 2.19 (95% CI 1.26–3.83), respectively. ^[156] The cohort also found that women with previous surgery had more active disease, emphasizing that observed pregnancy risk may reflect disease activity rather than surgical history itself. ^[156]

Medication safety and infant considerations

Available pregnancy evidence is strongest for established therapies, whereas data for newer agents remain limited. A 2026 systematic review and meta-analysis included 67 observational studies and 17,441 pregnancies exposed to advanced therapies and evaluated early pregnancy loss, preterm birth, congenital malformations, small-for-gestational-age birth, and other adverse outcomes. The pooled prevalence of early pregnancy loss was 8.2% (95% CI 6.2–10.8); the abstract also reported an overall preterm-birth estimate of 8.9% (95% CI 7.9–...), although the supplied reference does not provide the complete interval or class-specific results. ^[22] Anti-TNF therapy was described as having a well-established safety evidence base, while evidence for vedolizumab, ustekinumab, and Janus kinase inhibitors was characterized as more limited. ^[22]

Vedolizumab-specific evidence is expanding. A prospective registry followed 275 pregnancies from the United States and Canada: 99 vedolizumab-exposed pregnancies, 76 disease-matched pregnancies exposed to another biologic, and 100 pregnancies without chronic health conditions. Maternal and infant follow-up continued to 1 year postpartum, and the registry assessed major pregnancy, birth, and infant outcomes. ^[158] A separate updated systematic review and meta-analysis synthesized cohort studies and randomized trials through June 26, 2025, examining live birth, preterm birth, early pregnancy loss, caesarean delivery, congenital malformations, small-for-gestational-age birth, and composite perinatal complications after vedolizumab exposure. ^[102]

International guidance generally supports continuing indicated immunomodulating treatment during pregnancy rather than exposing the mother and fetus to active disease or relapse risk. ^[159] In a prospective cohort of women with IBD and their infants, maternal immunomodulating therapy and maternal Tdap vaccination were evaluated for effects on transplacental antibody transfer. ^[159] Another study used detailed flow cytometry and cytokine assays during pregnancy, at delivery, postpartum, and at 6 weeks of age to examine maternal and infant immune phenotypes after in-utero exposure to IBD therapies. ^[160]^C

Monitoring and diagnostic evaluation

The ECCO–ESGAR–ESP–IBUS diagnostic and monitoring guideline provides recommendations for initial diagnosis, complication detection, treatment monitoring, pregnancy-related diagnostics, postoperative assessment, and cancer surveillance. ^[97] Monitoring during pregnancy should be proactive and adapted to symptoms, objective inflammatory assessment, nutritional needs, and fetal and obstetric circumstances, while avoiding unnecessary diagnostic delay. ^[97]^[150]^[151]^[152]^[153]^[154]^[155]

Delivery and perineal considerations

Delivery planning should be individualized according to disease phenotype, obstetric indications, prior surgery, and the presence or absence of active perianal disease. ^[150]^[151]^[152]^[153]^[154]^[155] A study of primiparous women with singleton, cephalic, term vaginal births specifically examined perineal injury in IBD without active perianal disease; women with active perianal disease were excluded according to institutional guidance. ^[161] A population-based Ontario matched cohort evaluated severe maternal morbidity from 20 weeks’ gestation through 42 days postpartum and assessed whether delivery method altered risk among individuals with CD or ulcerative colitis (UC). ^[66]^D

Children and adolescents

Acute severe colitis (ASC) is a relatively frequent and potentially emergency presentation of paediatric UC. Updated ESPGHAN–ECCO guidance recommends a standardized, proactive approach based on close monitoring and timely medical and surgical intervention to improve outcomes. ^[98]

Environmental and medication exposures

A systematic review and meta-analysis evaluated passive-smoking exposure in relation to IBD incidence and disease outcomes for CD and UC using PRISMA and MOOSE methods and searches through May 2025. ^[99] The supplied abstract describes the research question and methodology but does not provide the pooled effect estimates; passive-smoking counselling should therefore be incorporated into preventive care without attributing a specific magnitude of risk from this reference alone. ^[99]

A nationwide South Korean mother–child cohort examined whether prenatal exposure to proton-pump inhibitors or H2-receptor antagonists was associated with incident IBD, CD, or UC in offspring, with follow-up through December 31, 2023. ^[129] The supplied abstract establishes the cohort design and outcome question but does not provide the study’s effect estimates; these medications should not be stopped or continued solely on the basis of an unreported association. ^[129]

Special-population priorities

Population or issue	Evidence-based priority
Pregnancy	Maintain disease control and individualize medication and delivery decisions. ^[150]^[151]^[152]^[153]^[154]^[155]
Crohn’s disease surgery history	Previous surgery alone was not associated with adverse pregnancy or neonatal outcomes. ^[156]
Advanced therapies	Interpret newer-agent pregnancy data cautiously; anti-TNF evidence is comparatively established. ^[22]
Vedolizumab exposure	Use registry and systematic-review data when counselling, recognizing that evidence remains observational and evolving. ^[102]^[158]
Paediatric ASC	Use standardized close monitoring with timely medical and surgical intervention. ^[98]
Passive smoking or prenatal acid suppression	Counsel and interpret associations using the reported study results; the supplied abstracts do not provide effect estimates. ^[99]^[129]

References

[1]
Phillips J, Tambakis G, Kumar R et al.. “Understanding heterogeneity in the pathogenesis and drug responses of ulcerative colitis through single-cell and spatial transcriptomics.” Frontiers in immunology (2026). PMID: 41988199 ↗
L2aSR_OBSCited in: Definition, Synonyms, and Classification
[2]
Lim CT, Pruijt M, Lim GH et al.. “Transperineal ultrasonography in detecting penetrating perianal disease: a systematic review and meta-analysis.” Journal of Crohn's & colitis (2026). PMID: 41873840 ↗
L2aSR_OBSCited in: Definition, Synonyms, and Classification
[3]
Heilmann RM, Jergens AE, Kathrani A et al.. “ACVIM-endorsed statement: consensus statement and systematic review on guidelines for the diagnosis and treatment of chronic inflammatory enteropathy in dogs.” Journal of veterinary internal medicine (2026). PMID: 41742497 ↗
L2aSR_OBSCited in: Definition, Synonyms, and Classification
[4]
Pelly T, Anand E, Holubar S et al.. “Systematic review: The management of unhealed wounds and persistent perineal sinuses following proctectomy in inflammatory bowel disease.” Techniques in coloproctology (2025). PMID: 41359092 ↗
L2aSR_OBSCited in: Definition, Synonyms, and Classification
[5]
Al-Shbailat SA, Alqato S, Alkhalaileh AY et al.. “Risk Factors and Outcomes of Immunoglobulin A Vasculitis in Patients with Inflammatory Bowel Disease and vice versa: A Systematic Review of the current literature.” Current gastroenterology reports (2026). PMID: 41569327 ↗
L2aSR_OBSCited in: Definition, Synonyms, and Classification
[6]
Wang Y, Sun X, Chen J et al.. “Associations between oral health problems and inflammatory bowel disease: evidence from prospective cohort study.” Frontiers in immunology (2026). PMID: 41909690 ↗
L2bCOHORTCited in: Definition, Synonyms, and Classification, Epidemiology and Risk Factors
[7]
Bælum JK, Rosenberg J, Larsen P et al.. “Extended mesenteric resection in Crohn's disease: EXCEED Study Protocol-a blinded multicenter randomized controlled clinical trial (RCT).” Trials (2025). PMID: 41272703 ↗
L2bTRIAL_NONRANDOMCited in: Definition, Synonyms, and Classification
[8]
Zhang W, Xie H, Ying S et al.. “Crohn's disease: research progress in decoding pathogenic multi-network and precision management of artificial intelligence radiomics.” Frontiers in immunology (2026). PMID: 41909686 ↗
L5REVIEW_NARRATIVECited in: Definition, Synonyms, and Classification
[9]
Lanier MH, Hoegger MJ, Itani M et al.. “MRI of Perianal Fistulas: Anatomy, Diagnosis, and Perianal Crohn Disease Treatment Monitoring.” Radiographics : a review publication of the Radiological Society of North America, Inc (2026). PMID: 41678368 ↗
L5REVIEW_NARRATIVECited in: Definition, Synonyms, and Classification
[10]
Wu D, Matsuda T, Xie D et al.. “NOD2-Related Multisystem Inflammatory Disorders and Recent Advances.” Current rheumatology reports (2026). PMID: 41678017 ↗
L5REVIEW_NARRATIVECited in: Definition, Synonyms, and Classification
[11]
Solitano V, Peyrin-Biroulet L, Vermeire S et al.. “Immunometabolism as a New Bimodal Therapeutic Concept in Inflammatory Bowel Disease and Immune-Mediated Inflammatory Disorders.” Inflammatory bowel diseases (2026). PMID: 41665650 ↗
L5REVIEW_NARRATIVECited in: Definition, Synonyms, and Classification
[12]
Puca P, Coppola G, Parello S et al.. “Atherosclerotic cardiovascular disease and inflammatory bowel disease: epidemiology, pathogenesis and risk assessment.” Best practice & research. Clinical gastroenterology (2025). PMID: 41350098 ↗
L5REVIEW_NARRATIVECited in: Definition, Synonyms, and Classification
[13]
Yang L, Jiang Z, Sun Q et al.. “The inflammation-aging axis: Shared and distinct mechanisms in physiological gut aging and IBD-associated accelerated gut aging.” Bioscience trends (2026). PMID: 41260668 ↗
L5REVIEW_NARRATIVECited in: Definition, Synonyms, and Classification
[14]
Lewis A, Ulsamer T, Franco L et al.. “Beyond Nutrients: NOVA-Defined Dietary Patterns in Crohn's Disease and Healthy Adults.” Nutrients (2026). PMID: 41978118 ↗
L1bRCTCited in: Definition, Synonyms, and Classification
[15]
Yamamoto T. “Leucine-rich alpha-2 glycoprotein as a blood biomarker in inflammatory bowel disease: clinical implications and future perspectives.” Expert review of gastroenterology & hepatology (2026). PMID: 41636455 ↗
L5REVIEW_NARRATIVECited in: Definition, Synonyms, and Classification
[16]
Zhan XY, Xu R, Hu LZ et al.. “Indigo Naturalis regulates the gut microbiota to increase SCFAs content and improve ulcerative colitis lesions.” Frontiers in cellular and infection microbiology (2026). PMID: 41987898 ↗
L5OTHERCited in: Definition, Synonyms, and Classification, Epidemiology and Risk Factors
[17]
Mahdy AKH, ElAbd H, Prinzensteiner M et al.. “Mapping adaptive immune responses toward fungal antigens in inflammatory bowel disease using T cell repertoire sequencing and phage-immunoprecipitation sequencing.” Journal of Crohn's & colitis (2026). PMID: 41974192 ↗
L5OTHERCited in: Definition, Synonyms, and Classification
[18]
Liu W, Wang S, Wang G et al.. “Pharmacovigilance analysis of infliximab in inflammatory bowel disease: novel safety signals and sex-specific adverse event profiles from the FAERS database (2004-2024).” Frontiers in immunology (2026). PMID: 41953029 ↗
L5OTHERCited in: Definition, Synonyms, and Classification, Epidemiology and Risk Factors, Management
[19]
Niyigena E, Hoffert Y, Afif W et al.. “Personalized infliximab rescue therapy to maximize colectomy-free survival in patients with acute severe ulcerative colitis.” Journal of Crohn's & colitis (2026). PMID: 41873130 ↗
L5OTHERCited in: Definition, Synonyms, and Classification, Management
[20]
Li X, Zhang H, Wang Q et al.. “C-terminal Fragment Generated by HOIL-1 Cleavage Suppresses Inflammatory Responses of Myeloid Cells to Alleviate Colitis.” Theranostics (2026). PMID: 41799187 ↗
L5OTHERCited in: Definition, Synonyms, and Classification
[21]
Liu J, Sun X, Yuan P et al.. “Clinical response and risk factors of fecal microbiota transplantation in children: a systematic review and meta-analysis.” European journal of pediatrics (2026). PMID: 41975112 ↗
L2aSR_OBSCited in: Epidemiology and Risk Factors
[22]
Moraes BF, Leite GAPD, Visentini LM et al.. “Safety of advanced therapies in pregnant women with inflammatory bowel disease: a systematic review and Meta-Analysis.” Journal of Crohn's & colitis (2026). PMID: 41874976 ↗
L2aSR_OBSCited in: Epidemiology and Risk Factors, Management, Special Populations
[23]
Giusto EA, Pinton P, Giorgi C et al.. “Risk of intestinal cancer in Crohn's disease: re-analysis and meta-regression of population-based cohort studies.” Journal of Crohn's & colitis (2026). PMID: 41778611 ↗
L2aSR_OBSCited in: Epidemiology and Risk Factors
[24]
Xu T, Chen Y, Shen Q et al.. “A systematic review and meta-analysis of anxiety and depression in children and adolescents with inflammatory bowel disease: Prevalence and association.” Journal of psychiatric research (2026). PMID: 41687568 ↗
L2aSR_OBSCited in: Epidemiology and Risk Factors
[25]
Wang W, Liu H, Wei W et al.. “Inflammatory bowel disease and the risk of all caused or specific fracture: a meta-epidemiologic study.” Frontiers in endocrinology (2026). PMID: 41685240 ↗
L2aSR_OBSCited in: Epidemiology and Risk Factors
[26]
Shen Y, Jiang Y, Wang Y et al.. “Increased risk of venous thromboembolism in children and teenagers with inflammatory bowel disease: a systematic review and meta-analysis.” PeerJ (2026). PMID: 41940394 ↗
L2aSR_OBSCited in: Epidemiology and Risk Factors
[27]
Kogias D, Kouklakis G, Papadopoulos V. “Hepatitis E Infection in Patients With Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis.” Journal of viral hepatitis (2026). PMID: 41721452 ↗
L2aSR_OBSCited in: Epidemiology and Risk Factors
[28]
Koroma MM, Chan J, Michaux M et al.. “Pooled prevalence of psychological distress and mental health conditions in older adults with inflammatory bowel disease: a protocol for a systematic review and meta-analysis.” Systematic reviews (2026). PMID: 41721426 ↗
L2aSR_OBSCited in: Epidemiology and Risk Factors
[29]
Zhang Q, Xu F, Liu S et al.. “Long-term risk of bowel resection and mortality associated with sleep behaviours and sleep pattern in patients with inflammatory bowel disease: a large-scale prospective cohort study.” Family medicine and community health (2026). PMID: 41760375 ↗
L2bCOHORTCited in: Epidemiology and Risk Factors
[30]
Kumar S, Plumb A, Mallett S et al.. “Magnetic resonance enterography to predict disabling disease in newly diagnosed Crohn's disease: the METRIC-EF multivariable prediction model, multicentre diagnostic inception cohort study.” Health technology assessment (Winchester, England) (2026). PMID: 41699939 ↗
L2bCOHORTCited in: Epidemiology and Risk Factors
[31]
Chen J, Li L, Ran Y et al.. “Exposure to outdoor artificial light at night is associated with a higher risk of ulcerative colitis: a prospective cohort study from the UK Biobank.” Frontiers in public health (2026). PMID: 41694500 ↗
L2bCOHORTCited in: Epidemiology and Risk Factors
[32]
Nardone OM, D'Amico F, Calabrese G et al.. “Risk of avoidant/restrictive food intake disorders in patients with inflammatory bowel disease: a matched cross-sectional case-control study.” Journal of Crohn's & colitis (2026). PMID: 41974193 ↗
L3bCASE_CONTROLCited in: Epidemiology and Risk Factors
[33]
Zhang Q, Gui P, Liu S et al.. “Long-Term Risk of Inflammatory Bowel Disease With Sarcopenia Status: A Large-Scale Prospective Cohort Study.” Geriatrics & gerontology international (2026). PMID: 41932853 ↗
L2bCOHORTCited in: Epidemiology and Risk Factors
[34]
Yap JM, Wall CL, Meredith-Jones K et al.. “A Randomised Controlled Trial Comparing the Effects of Personalised Diet and Physical Activity Intervention Versus Usual Care on Cardiometabolic Risk Factors in Adults with Inactive Inflammatory Bowel Disease.” Nutrients (2026). PMID: 41829955 ↗
L1bRCTCited in: Epidemiology and Risk Factors
[35]
Xu T, Xie Y. “Clinical characteristics and risk factors analysis of Clostridioides difficile infection in ulcerative colitis patients during biologic therapy.” Frontiers in cellular and infection microbiology (2026). PMID: 41969661 ↗
L5OTHERCited in: Epidemiology and Risk Factors, Management
[36]
Fries W, Costantino G, Viola A. “Managing Acute Severe Ulcerative Colitis in the Older Patient: A Growing Concern.” Drugs & aging (2026). PMID: 41886038 ↗
L5REVIEW_NARRATIVECited in: Epidemiology and Risk Factors
[37]
Choi SJ, Choi ES, Kim HY et al.. “Revised Criterion for Identifying Small-Bowel Stricture in Crohn Disease at CT Enterography.” Radiology (2026). PMID: 41874296 ↗
L5OTHERCited in: Epidemiology and Risk Factors
[38]
Shen H, Yu X, Wang Z et al.. “Gut Microbiota Remodeling Mediates the Therapeutic Effects of a Plant-Based Medicine on DSS-Induced Ulcerative Colitis in Mice via the Butyrate-SVCT1-Vitamin C Axis.” International journal of molecular sciences (2026). PMID: 41828467 ↗
L5OTHERCited in: Epidemiology and Risk Factors
[39]
Lyu W, Zhang Z, Liu L et al.. “Gut microbiota and macrophage crosstalk: implications for colitis-associated colorectal cancer.” Frontiers in cellular and infection microbiology (2026). PMID: 41816358 ↗
L5REVIEW_NARRATIVECited in: Epidemiology and Risk Factors
[40]
Fouad Y, Aboelela AS. “Lessons from extended induction and practical evidence for improving tofacitinib therapy in ulcerative colitis.” World journal of gastroenterology (2026). PMID: 41810448 ↗
L5OTHERCited in: Epidemiology and Risk Factors
[41]
Zeng SH, Jiang XY, Lin DR et al.. “Mechanisms and therapeutic potential of traditional Chinese medicine for inflammatory bowel disease.” World journal of gastroenterology (2026). PMID: 41809460 ↗
L5REVIEW_NARRATIVECited in: Epidemiology and Risk Factors
[42]
Zhao Y, Zhai X, Wang H et al.. “A multi-machine learning framework identifies novel PANoptosis-related biomarkers and their immune landscape in ulcerative colitis: Insights from transcriptomics and experimental validation.” Frontiers in immunology (2026). PMID: 41789070 ↗
L5OTHERCited in: Epidemiology and Risk Factors
[43]
Zou Q, Zhang W, Xie H et al.. “Inflammatory bowel disease through the lens of microbe-host interactions: immunomodulation, metabolic effects, and genetic susceptibility in microbiota dysbiosis.” Frontiers in cellular and infection microbiology (2026). PMID: 41778020 ↗
L5REVIEW_NARRATIVECited in: Epidemiology and Risk Factors
[44]
Chen L, Hua J. “Identification of Novel Biomarkers for Crohn's Disease Through the Integration of Machine Learning, Colocalization, and SMR Analysis.” FASEB journal : official publication of the Federation of American Societies for Experimental Biology (2026). PMID: 41773807 ↗
L5OTHERCited in: Epidemiology and Risk Factors
[45]
Bahaa MM, Abdallah MS, Mosalam EM et al.. “Ulcerative colitis, pathophysiological mechanisms and drug repurposing: a new therapeutic dawn-narrative review.” Inflammopharmacology (2026). PMID: 41770503 ↗
L5REVIEW_NARRATIVECited in: Epidemiology and Risk Factors
[46]
He Z, Zhang YN, Wei JC et al.. “Increased risk of inflammatory bowel disease in ankylosing spondylitis compared to psoriasis.” Frontiers in immunology (2026). PMID: 41727477 ↗
L5OTHERCited in: Epidemiology and Risk Factors
[47]
Kumar S, Sarkar B. “From rodents to chips: preclinical models of inflammatory bowel disease with emphasis on host-microbiome interactions.” American journal of physiology. Gastrointestinal and liver physiology (2026). PMID: 41721794 ↗
L5REVIEW_NARRATIVECited in: Epidemiology and Risk Factors
[48]
Colombel JF, Danese S, Schreiber S et al.. “Impact of Immunogenicity on Clinical Outcomes in Patients With Moderate-to-Severe Inflammatory Bowel Disease Receiving Subcutaneous Infliximab: A Post Hoc Analysis of the LIBERTY Trials.” United European gastroenterology journal (2026). PMID: 41986154 ↗
L1bRCTCited in: Management
[49]
Hart A, Sridhar S, Venkat S et al.. “Multiomic characterisation of the clinical efficacy of guselkumab induction therapy in ulcerative colitis.” BMJ open gastroenterology (2026). PMID: 41871904 ↗
L1bRCTCited in: Management
[50]
De Greef E, Turner D, Kierkuś J et al.. “Ustekinumab therapy for moderately to severely active pediatric Crohn's disease: UNITI Jr study safety and efficacy results in patients weighing at least 40 kg.” Journal of Crohn's & colitis (2026). PMID: 41843763 ↗
L1bRCTCited in: Management
[51]
Oldenburg L, Haanappel AEG, Ali M et al.. “Ileocaecal resection versus infliximab for ileal Crohn's disease: retrospective 10-year follow-up of the LIR!C trial.” The lancet. Gastroenterology & hepatology (2026). PMID: 41724174 ↗
L1bRCTCited in: Management
[52]
Randlová K, Marešová P, Režný L et al.. “Cost-effectiveness of treatment and care of patients with gastrointestinal inflammatory diseases: a systematic review.” Journal of medical economics (2026). PMID: 41861399 ↗
L2aSR_OBSCited in: Management
[53]
Dignass A, Narula N, Pratap K et al.. “IOlBD evidence-based consensus on the use of artificial intelligence for assessment of endoscopic and histologic endpoints in clinical trials of inflammatory bowel disease.” Journal of Crohn's & colitis (2026). PMID: 41802119 ↗
L2bTRIAL_NONRANDOMCited in: Management
[54]
Jairath V, Vuyyuru SK, Zou G et al.. “Evaluating treatment to a target of transmural healing in patients with moderately to severely active Crohn's disease: rationale, design and protocol for the randomised controlled VECTORS trial.” BMJ open gastroenterology (2026). PMID: 41720589 ↗
L2bTRIAL_NONRANDOMCited in: Management
[55]
Mould DR, Kutschera M, Primas C et al.. “Determination of correlation of clearance with clinical outcomes for inflammatory bowel disease.” World journal of gastroenterology (2026). PMID: 41693973 ↗
L2bTRIAL_NONRANDOMCited in: Management
[56]
El Ouali S, Baker ME, Lu C et al.. “Ustekinumab for ileal stricturing Crohn's disease-an international multicenter retrospective cohort study.” Journal of Crohn's & colitis (2026). PMID: 41934342 ↗
L2bCOHORTCited in: Management, Supportive Care and Complication Management
[57]
Calméjane L, Reenaers C, Gay C et al.. “Efficacy and Safety of Second-Line Advanced Therapy After Vedolizumab in Ulcerative Colitis: A Multicenter Cohort Study From the GETAID.” United European gastroenterology journal (2026). PMID: 41880233 ↗
L2bCOHORTCited in: Management
[58]
Tímár ÁE, Hernádfői M, Teutsch B et al.. “Association of extraintestinal manifestations and disease severity in paediatric inflammatory bowel disease: a multicentre cohort study.” BMJ open gastroenterology (2026). PMID: 41734978 ↗
L2bCOHORTCited in: Management
[59]
Mo R, Yu S, Xu H et al.. “Upadacitinib in refractory ulcerative colitis patients with high thromboembolic risk: two case reports.” Frontiers in immunology (2026). PMID: 41853288 ↗
L4CASE_REPORTCited in: Management
[60]
Kakiuchi T, Shimada S, Zhang Y et al.. “Case Report: Interleukin-23 blockade achieves sustained remission in Niemann-Pick type C-associated Crohn's disease refractory to anti-tumor necrosis factor therapy.” Frontiers in immunology (2026). PMID: 41798938 ↗
L4CASE_REPORTCited in: Management
[61]
Nitskovich R, Jóźwik A, Sobolewski P et al.. “Bowel-Associated Dermatosis and Arthritis Syndrome (BADAS) - A Literature Review With Diagnostic and Therapeutic Implications and a Report of Two Cases of BADAS Associated With Inflammatory Bowel Disease.” Archivum immunologiae et therapiae experimentalis (2026). PMID: 41722086 ↗
L4CASE_REPORTCited in: Management, Supportive Care and Complication Management
[62]
Li Z, Sun Y, Wu J et al.. “Mesenchymal Stem Cells Derived Extracellular Vesicles in Inflammatory Bowel Disease: Therapeutic Efficacy and Bioengineering Applications.” International journal of nanomedicine (2026). PMID: 41993781 ↗
L5REVIEW_NARRATIVECited in: Management
[63]
Gao J, Liu Y, Xia T et al.. “Mapping the landscape and future directions of stem cell therapy for inflammatory bowel disease.” Stem cell research & therapy (2026). PMID: 41992341 ↗
L5REVIEW_NARRATIVECited in: Management
[64]
Mori M, Nakao YM, Honda M et al.. “COVID-19 State of Emergency and Biological Therapy Persistence for Ulcerative Colitis: An Interrupted Time Series Study Using a Nationwide Claims Database.” Pharmacoepidemiology and drug safety (2026). PMID: 41990848 ↗
L5OTHERCited in: Management
[65]
Raine T, Lewis JD, Parkes GC et al.. “Real-world patient characteristics, treatments, and outcomes during and after severe ulcerative colitis hospitalization.” Journal of Crohn's & colitis (2026). PMID: 41978350 ↗
L5OTHERCited in: Management
[66]
Simpson AN, Sutradhar R, Benchimol EI et al.. “Assessing the impact of delivery method on severe maternal morbidity among individuals with inflammatory bowel disease: a population-based study.” Journal of Crohn's & colitis (2026). PMID: 41964942 ↗
L5OTHERCited in: Management
[67]
Dreznik Y, Sharabi S, Shouval D et al.. “Surgically Treated Perianal Abscess in Children: Clinical Characteristics and Subsequent Diagnosis of Crohn's Disease.” European journal of pediatrics (2026). PMID: 41964806 ↗
L5OTHERCited in: Management
[68]
Pérez-Galindo P, Gisbert JP, Carrillo-Palau M et al.. “Influence of vedolizumab on extraintestinal manifestations in inflammatory bowel disease: a nationwide multicenter study of the GETECCU ENEIDA Registry.” Journal of Crohn's & colitis (2026). PMID: 41886507 ↗
L5OTHERCited in: Management
[69]
Roblin X, Nancey S, Papamichael K et al.. “Higher Colonic Tissue Drug Concentrations of Subcutaneous Compared to Intravenous Administration of Infliximab Therapy in Patients With Inflammatory Bowel Disease.” United European gastroenterology journal (2026). PMID: 41880240 ↗
L5OTHERCited in: Management
[70]
Meningher T, Finkel O, Nayshool O et al.. “Transcriptomic profiling of fecal aspirates as a tool for prediction of endoscopic inflammation in small bowel Crohn's disease.” Journal of Crohn's & colitis (2026). PMID: 41879069 ↗
L5OTHERCited in: Management
[71]
Wendt ER, Liang Y, Park G et al.. “Filgotinib treatment modulates frequency and gene expression of circulating immune cell subsets in ulcerative colitis.” Journal of Crohn's & colitis (2026). PMID: 41879068 ↗
L5OTHERCited in: Management
[72]
Hudson AS, Isaac DM, Ma H et al.. “Early intestinal ultrasound findings predict remission and treatment response at 1 year in pediatric Crohn's disease.” Journal of Crohn's & colitis (2026). PMID: 41866919 ↗
L5OTHERCited in: Management
[73]
Zafeiropoulou K, Hageman IL, Mu T et al.. “Colonic biopsy-associated microbial signatures are predictive of response to anti-TNFα biological therapy in Crohn's disease.” Frontiers in cellular and infection microbiology (2026). PMID: 41859469 ↗
L5OTHERCited in: Management
[74]
Jairath V, Adsul S, Allocca M et al.. “Integrating Intestinal Ultrasound to Clinical Trials in Patients With Crohn's Disease: Opportunities and Challenges.” Inflammatory bowel diseases (2025). PMID: 40971817 ↗
L2bTRIAL_NONRANDOMCited in: Supportive Care and Complication Management
[75]
Pigneur B, Martinez-Vinson C, Bourmaud A et al.. “Cyclic exclusive enteral nutrition versus partial enteral nutrition to maintain long-term drug-free remission in paediatric Crohn's disease (CD-HOPE): an open-label, endpoint-blinded, randomised controlled trial.” The lancet. Gastroenterology & hepatology (2026). PMID: 41570843 ↗
L1bRCTCited in: Supportive Care and Complication Management
[76]
Zhang M, Tu Q, Luo K et al.. “Postoperative exclusive enteral nutrition as a bridging therapy to reduce endoscopic recurrence after intestinal resection in Crohn's disease: A randomized controlled trial.” Clinical nutrition (Edinburgh, Scotland) (2026). PMID: 41483478 ↗
L1bRCTCited in: Supportive Care and Complication Management
[77]
Li CC, Xu LP, Zheng TT et al.. “The effects of steroid treatment on osteoporosis in patients with inflammatory bowel disease: A systematic review and meta-analysis.” Medicine (2026). PMID: 41560068 ↗
L2aSR_OBSCited in: Supportive Care and Complication Management
[78]
Shinagawa T, Okada S, Shiratori H et al.. “Statistics and epidemiology of inflammatory bowel disease-associated colorectal neoplasia.” International journal of clinical oncology (2026). PMID: 41721152 ↗
L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
[79]
Yan Y, Du R, Xia C et al.. “Nutritional trace elements influence the pathogenesis and resolution of inflammatory bowel disease.” Food & function (2026). PMID: 41685405 ↗
L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
[80]
Wilk A, Pawłowski M, Balcerczak E et al.. “Advances in the Treatment of Ulcerative Colitis-From Conventional Therapies to Targeted Biologics and Small Molecules.” International journal of molecular sciences (2026). PMID: 41683952 ↗
L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
[81]
Baharad Y, Engel T, Ben-Horin S. “Dietary therapy for small bowel Crohn's disease.” Current opinion in gastroenterology (2026). PMID: 41612628 ↗
L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
[82]
Axi L, Wang Y, Meng W. “Research progress on exclusive enteral nutrition combined with biologics in the treatment of adult Crohn's disease.” Journal of Crohn's & colitis (2026). PMID: 41452759 ↗
L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
[83]
Arnim UV, Scholz K. “Fatigue in inflammatory bowel disease.” Best practice & research. Clinical gastroenterology (2025). PMID: 41350094 ↗
L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
[84]
Roseira J, Estevinho MM, Gros B et al.. “Advances in endoscopy in IBD diagnostics and management.” Best practice & research. Clinical gastroenterology (2025). PMID: 41350091 ↗
L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
[85]
Hoffmann NV, Hobbs E, Wershil BK. “Nutritional Therapy in Pediatric Allergic Bowel Disease.” Gastroenterology clinics of North America (2025). PMID: 41238283 ↗
L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
[86]
Masthan A, Strople J, Runde J. “Dietary Therapy in the Management of Inflammatory Bowel Disease: A Lasting Legacy and a New Frontier.” Gastroenterology clinics of North America (2025). PMID: 41238281 ↗
L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
[87]
Tesoi DF, Hancianu M, Trandafir LM et al.. “Thrombosis and Anemia in Pediatric Inflammatory Bowel Disease: Pathophysiology, Clinical Impact and Future Directions.” International journal of molecular sciences (2025). PMID: 41226447 ↗
L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
[88]
Di Vincenzo F, Del Vecchio LE, Covello C et al.. “Beyond the mucosa: The emerging role of endoscopic ultrasound in the diagnosis and management of inflammatory bowel disease.” Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (2026). PMID: 41188166 ↗
L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
[89]
Eggermont E, Gecse K, Krugliak Cleveland N et al.. “Ulcerative colitis: moving beyond the mucosal dogma.” The lancet. Gastroenterology & hepatology (2026). PMID: 41173014 ↗
L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
[90]
El Sadaney AO, Baker ME, Ream J et al.. “Toward eliminating missed important findings in fibrostenosing Crohn's disease at CT and MR enterography.” Abdominal radiology (New York) (2026). PMID: 41171404 ↗
L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
[91]
Shet SS, Lee RJ, Kakish E et al.. “Patient radiation safety in imaging in Crohn's disease.” The British journal of radiology (2026). PMID: 41160487 ↗
L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
[92]
Hoodeshenas S, Dillman JR, Taylor SA et al.. “Crohn Disease Strictures: Multimodality Imaging to Identify Imaging Biomarkers.” Radiographics : a review publication of the Radiological Society of North America, Inc (2025). PMID: 41100354 ↗
L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
[93]
Marind EC, McCullough F. “Gut Health Responses to Nutritional Interventions in Paediatric Crohn's Disease, Including the Potential Outcomes of Mucosal Barrier Preservation: A Systematic Review.” Nutrients (2026). PMID: 41978196 ↗
L2aSR_OBSCited in: Supportive Care and Complication Management
[94]
Rocchi C, Massidda M, Piroddu J et al.. “Endoscopic Stricturotomy for the Treatment of Inflammatory Bowel Diseases' Ileocolonic Strictures: A Systematic Review.” Journal of gastrointestinal and liver diseases : JGLD (2025). PMID: 41004825 ↗
L2aSR_OBSCited in: Supportive Care and Complication Management
[95]
Rohani P, Ansari A, Shaygantabar M et al.. “The Effects of the Crohn's Disease Exclusion Diet (CDED) Alone Versus CDED Plus Partial Enteral Nutrition (PEN) on Gut Microbiome Composition in Pediatric CD Patients.” MicrobiologyOpen (2025). PMID: 41133990 ↗
L1bRCTCited in: Supportive Care and Complication Management
[96]
Cataletti G, Gridavilla D, Casella M et al.. “Multiparametric intestinal ultrasound in inflammatory bowel diseases: a narrative review.” Expert review of gastroenterology & hepatology (2026). PMID: 41635930 ↗
L5REVIEW_NARRATIVECited in: Supportive Care and Complication Management
[97]
Kucharzik T, Taylor S, Allocca M et al.. “ECCO-ESGAR-ESP-IBUS Guideline on Diagnostics and Monitoring of Patients with Inflammatory Bowel Disease: Part 1.” Journal of Crohn's & colitis (2025). PMID: 40741688 ↗
L1cGUIDELINECited in: Special Populations
[98]
Assa A, Aloi M, Van Biervliet S et al.. “Management of paediatric ulcerative colitis, part 2: Acute severe colitis-An updated evidence-based consensus guideline from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition and the European Crohn's and Colitis Organization.” Journal of pediatric gastroenterology and nutrition (2025). PMID: 40528309 ↗
L1cGUIDELINECited in: Special Populations
[99]
Mahajan A, Gupta B, Peterson A et al.. “Passive smoking exposure and incidence and disease outcomes of inflammatory bowel disease: a systematic review and meta-analysis.” Frontiers in public health (2025). PMID: 41235209 ↗
L2aSR_OBSCited in: Special Populations
[100]
Al Awadhi S, Al Hassani A, El Ouali S et al.. “Second United Arab Emirates consensus guidance on the diagnosis and management of inflammatory bowel disease.” World journal of gastroenterology (2025). PMID: 41024766 ↗
L2aSR_OBSCited in: Special Populations
[101]
Joudaki S, Oladipupo O, Carbery I et al.. “Meta-Analysis: Pregnancies With Inflammatory Bowel Disease Complicated by Intrahepatic Cholestasis of Pregnancy.” Alimentary pharmacology & therapeutics (2025). PMID: 40114011 ↗
L2aSR_OBSCited in: Special Populations
[102]
Nguyen B, Quon S, Williams AJ et al.. “Safety of Vedolizumab in Pregnancy: An Updated Systematic Review and Comprehensive Meta-analysis.” Journal of clinical gastroenterology (2026). PMID: 41397157 ↗
L2aSR_OBSCited in: Special Populations
[103]
Bardak AE, Saeed H, Teker G et al.. “Comparative safety of ustekinumab versus anti-TNF therapy during pregnancy in patients with inflammatory bowel disease: A systematic review and meta-analysis.” Medicine (2025). PMID: 40958297 ↗
L2aSR_OBSCited in: Special Populations
[104]
Mark-Christensen A, Ebert AC, Poulsen GJ et al.. “Risk of adverse pregnancy and birth outcomes after open versus laparoscopic surgery for inflammatory bowel disease: a nationwide cohort study.” Journal of Crohn's & colitis (2026). PMID: 41437648 ↗
L2bCOHORTCited in: Special Populations
[105]
Azzam N, Almadi M, Alfarhan H et al.. “The Impact of Disease Activity and Medications on Pregnancy and Fetal Outcomes in Women With Inflammatory Bowel Disease: A Cohort Study From the IBD-ME Group.” Journal of gastroenterology and hepatology (2026). PMID: 41239802 ↗
L2bCOHORTCited in: Special Populations
[106]
Mårild K, Söderling J, Stephansson O et al.. “Inflammatory Bowel Disease, Periconceptional Disease Activity, and Risk of Major Congenital Anomalies: A Nationwide Cohort Study.” The American journal of gastroenterology (2025). PMID: 39945675 ↗
L2bCOHORTCited in: Special Populations
[107]
Friedman S, Garvik OS, Nielsen J et al.. “The Consequences of Preterm Birth in the Children of Mothers with Inflammatory Bowel Disease: A Nationwide Cohort Study.” Inflammatory bowel diseases (2025). PMID: 39899387 ↗
L2bCOHORTCited in: Special Populations
[108]
Devi J, Samaan S, Syal G et al.. “Biomarkers for Disease Activity in Inflammatory Bowel Disease.” Gastroenterology clinics of North America (2026). PMID: 41581945 ↗
L5REVIEW_NARRATIVECited in: Special Populations
[109]
Yılmaz M, Gökçe A, Öztürk O. “What Is the Real Impact of Smoking on Diseases Alleged to Benefit from It?” European addiction research (2025). PMID: 41129423 ↗
L5REVIEW_NARRATIVECited in: Special Populations
[110]
Ribeiro-Mourão F, Agrawal M, Torres J et al.. “Intervention(s) in the Early-Life Period to Modulate Inflammatory Bowel Disease Risk: What Could Be the Impact?” Inflammatory bowel diseases (2025). PMID: 41078161 ↗
L5REVIEW_NARRATIVECited in: Special Populations
[111]
Al-Beltagi M, Saeed NK, Mani PKC et al.. “Inflammatory bowel disease in paediatrics: Navigating the old challenges and emerging frontiers.” World journal of gastroenterology (2025). PMID: 41024758 ↗
L5REVIEW_NARRATIVECited in: Special Populations
[112]
Pal P, Mateen MA, Pooja K et al.. “Transperineal ultrasound: Role in inflammatory bowel disease management.” World journal of gastroenterology (2025). PMID: 40933455 ↗
L5REVIEW_NARRATIVECited in: Special Populations
[113]
Freitas Queiroz NS, Furfaro F. “Pregnancy and IBD: A practical guide for physicians.” Best practice & research. Clinical gastroenterology (2025). PMID: 40769612 ↗
L5REVIEW_NARRATIVECited in: Special Populations
[114]
Kuk N, Yao CK, Srinivasan AR et al.. “Nutrition in inflammatory bowel disease: new trends.” Current opinion in clinical nutrition and metabolic care (2025). PMID: 40657733 ↗
L5REVIEW_NARRATIVECited in: Special Populations
[115]
Feuerstein JD, Rubin DT, Aberra FN et al.. “Appropriate Use and Complications of Corticosteroids in Inflammatory Bowel Disease: A Comprehensive Review.” Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association (2025). PMID: 40588110 ↗
L5REVIEW_NARRATIVECited in: Special Populations
[116]
Reinisch W, Stepek D, Kempinski R et al.. “Efficacy and safety of duvakitug in patients with ulcerative colitis (RELIEVE UCCD): a phase 2b, randomised, placebo-controlled trial.” The lancet. Gastroenterology & hepatology (2026). PMID: 42462750 ↗
L2bCited in: Epidemiology and Risk Factors
[117]
Ding C, Wang Y, Sun T et al.. “Association between OLD and IBD: a systematic review and meta-analysis.” Frontiers in immunology (2026). PMID: 42454054 ↗
L2aCited in: Epidemiology and Risk Factors
[118]
Eduard B, Roxana ZD, Dan V et al.. “Risk Factors and Predictive Biomarkers for Postoperative Complications in Crohn's Disease Surgery: Systematic Review.” International journal of molecular sciences (2026). PMID: 42450003 ↗
L2aCited in: Epidemiology and Risk Factors
[119]
Huo BL, Zhao AL, Liu W et al.. “Dual biologics or combination therapy with small molecules in pediatric inflammatory bowel disease: a systematic review and meta-analysis.” World journal of pediatrics : WJP (2026). PMID: 42387245 ↗
L2aCited in: Epidemiology and Risk Factors
[120]
Tesoi DF, Trandafir LM, Bozomitu L et al.. “Molecular Mechanisms Underlying the Higher Prevalence of Anemia in Crohn's Disease Compared with Ulcerative Colitis: A Systematic Review.” International journal of molecular sciences (2026). PMID: 42353283 ↗
L2aCited in: Epidemiology and Risk Factors
[121]
Su S, Zhou H, Wang Z et al.. “When intestinal ulceration meets hematologic malignancies: clinical features and mortality from a pooled individual-patient data systematic review.” Frontiers in immunology (2026). PMID: 42292435 ↗
L2aCited in: Epidemiology and Risk Factors
[122]
Ye BD, Kim HJ, Park DI et al.. “Five-Year Outcomes and Disease Trajectories in Moderate-to-Severe Ulcerative Colitis: A Korean Multicenter Inception Cohort.” Journal of gastroenterology and hepatology (2026). PMID: 42373568 ↗
L4Cited in: Epidemiology and Risk Factors
[123]
Khan SW, Al Hosani N, Swaid TK et al.. “Anti-TNF immunogenicity in a Middle Eastern inflammatory bowel disease cohort: prevalence, predictors and context-specific drug level thresholds.” BMJ open gastroenterology (2026). PMID: 42362204 ↗
L2bCited in: Epidemiology and Risk Factors
[124]
Green Z, Nicholas M, Vuijk S et al.. “Escalating anti-tumour necrosis factor exposure with reductions in surgical resection rates in paediatric inflammatory bowel disease: an 18-year real-world population-based cohort study.” BMJ open gastroenterology (2026). PMID: 42342332 ↗
L2bCited in: Epidemiology and Risk Factors
[125]
Zhang C, Liu G, Bi J et al.. “Retention of the ileocolic pedicle correlates with higher postoperative endoscopic recurrence risk in Crohn's disease ileocolic resection.” Journal of Crohn's & colitis (2026). PMID: 42501364 ↗
L3bCited in: Epidemiology and Risk Factors
[126]
Lyu N, Tracy M, Schneeweiss S et al.. “Risk of Infections With Infliximab vs Adalimumab Among Children With Inflammatory Bowel Disease.” JAMA network open (2026). PMID: 42430170 ↗
L3bCited in: Epidemiology and Risk Factors
[127]
Tariq R, Parmar K, Desai M et al.. “Rising Burden and Clinical Impact of Metabolic Syndrome in Inflammatory Bowel Disease: A Real-World Cohort Study.” United European gastroenterology journal (2026). PMID: 42424118 ↗
L3bCited in: Epidemiology and Risk Factors
[128]
Baekdal JA, Hansen ESH, Meteran H et al.. “Risk and outcome of interstitial lung disease in inflammatory bowel disease: evidence from a Danish nationwide population-based cohort study.” Journal of Crohn's & colitis (2026). PMID: 42378711 ↗
L3bCited in: Epidemiology and Risk Factors
[129]
Oh J, Park J, Kim H et al.. “Prenatal Exposure to Acid-Suppressive Medications and Incident Risk of Inflammatory Bowel Disease in Children.” JAMA network open (2026). PMID: 42340720 ↗
L3bCited in: Epidemiology and Risk Factors
[130]
Choi HI, Kim M, Moon JR et al.. “Adverse Events Associated with Advanced Therapy Compared with Conventional Therapy in Patients with Inflammatory Bowel Disease: A Common Data Model Analysis.” Gut and liver (2026). PMID: 42325013 ↗
L3bCited in: Epidemiology and Risk Factors
[131]
Gabbiadini R, Franchellucci G, Minini F et al.. “Virtual chromoendoscopy with linked color imaging versus dye-chromoendoscopy in the surveillance of patients with long-standing colonic inflammatory bowel disease.” Journal of Crohn's & colitis (2026). PMID: 42315966 ↗
L3bCited in: Epidemiology and Risk Factors
[132]
Plovgaard J, Wewer MD, Bendtsen F et al.. “Medical and surgical therapies for patients with inflammatory bowel diseases and prior or coexisting cancer: a Danish nationwide cohort study.” Journal of Crohn's & colitis (2026). PMID: 42302199 ↗
L3bCited in: Epidemiology and Risk Factors
[133]
Gimeno-Pitarch L, Iborra M, Crespo A et al.. “Risk of symptomatic leishmaniasis in patients with inflammatory bowel disease receiving biologic therapy in an endemic Mediterranean region: a population-based case-control study.” Journal of Crohn's & colitis (2026). PMID: 42257254 ↗
L4Cited in: Epidemiology and Risk Factors
[134]
Kraft M, Maroli A, Pera M et al.. “Subclinical anxiety and depression and postoperative complications after major colorectal surgery: A 2-center study.” Surgery (2026). PMID: 42224963 ↗
L4Cited in: Epidemiology and Risk Factors
[135]
Topala M, Ionescu V, Lupescu IG et al.. “Factors Associated with Frailty in Patients with Active Inflammatory Bowel Disease: A Single-Center Observational Study.” Medicina (Kaunas, Lithuania) (2026). PMID: 42356206 ↗
L4Cited in: Epidemiology and Risk Factors
[136]
Moran GP, McQuillan A, Ho GT et al.. “Modified Crohn's Disease Exclusion Diet and exclusive enteral nutrition (EEN) resolve oral dysbiosis in pediatric Crohn's disease: a prospective cohort study.” Inflammatory bowel diseases (2026). PMID: 42322204 ↗
L1bCited in: Supportive Care and Complication Management
[137]
Shaygantabar M, Dianati Z, Ledari SM et al.. “Exclusion diet vs. exclusion diet plus partial enteral nutrition in management of pediatric Crohn's disease.” BMC pediatrics (2026). PMID: 42231250 ↗
L1bCited in: Supportive Care and Complication Management
[138]
Huang X, Chen Y, Zhong Z et al.. “Effect of modified Mediterranean diet supplemented with partial enteral nutrition in post-surgical patients with Crohn's disease: a pilot clinical trial.” The British journal of nutrition (2026). PMID: 41749464 ↗
L4Cited in: Supportive Care and Complication Management
[139]
Mela E, Garoufalia Z, Emile SH et al.. “Εsophageal Crohn's disease in adults: A systematic review of the literature.” Surgery (2026). PMID: 42102534 ↗
L2aCited in: Supportive Care and Complication Management
[140]
Klomberg RCW, Griffiths AM, Aloi M et al.. “A comparative analysis of corticosteroids and exclusive enteral nutrition induction therapy in children with small bowel Crohn's disease: results of two prospective cohorts.” European journal of pediatrics (2026). PMID: 42154069 ↗
L2bCited in: Supportive Care and Complication Management
[141]
Azulay A, Gotesdyner L, Aharoni-Frutkoff Y et al.. “Multi-omics-based machine learning model predicts response and guides treatment in Crohn disease: a case study in nutritional therapy.” Inflammatory bowel diseases (2026). PMID: 42086326 ↗
L2bCited in: Supportive Care and Complication Management
[142]
Beek KJ, van Rijn K, de Voogd F et al.. “Utility of T2* and DWI-IVIM to distinguish inflammatory and noninflammatory strictures in Crohn's disease: a prospective cross-sectional cohort study.” European radiology experimental (2026). PMID: 42018022 ↗
L4Cited in: Supportive Care and Complication Management
[143]
Alla D, Appala S, Meyur S et al.. “Safety and efficacy of etrasimod in ulcerative colitis: Evidence from a meta-analysis.” Medicine (2026). PMID: 42332476 ↗
L1aCited in: Supportive Care and Complication Management
[144]
Kaur K, Singh A, Kaur S et al.. “Exclusive enteral nutrition for induction of remission in Crohn's disease in adults: A systematic review and meta-analysis of randomized trials and real-world studies.” Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology (2026). PMID: 42065851 ↗
L1aCited in: Supportive Care and Complication Management
[145]
Singh A, Rana U, Chandnani S et al.. “Mediterranean diet in treatment of inflammatory bowel disease: A systematic review and meta-analysis.” Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology (2026). PMID: 41803562 ↗
L1aCited in: Supportive Care and Complication Management
[146]
Subedi A, Chaar A, Suhail FK et al.. “Indirect comparison of endoscopic balloon dilatation, stent placement, and stricturotomy for lower gastrointestinal strictures in Crohn's disease: a systematic review and meta-analysis.” European journal of gastroenterology & hepatology (2026). PMID: 42335425 ↗
L2aCited in: Supportive Care and Complication Management
[147]
Rimola J, Anupindi S, Capozzi N et al.. “Comparison of Conventional versus Abbreviated MR Enterography: Assessing Disease Activity and Complications in Crohn Disease.” Radiology (2026). PMID: 42117993 ↗
L3bCited in: Supportive Care and Complication Management
[148]
Blandino AA, Caravan P, Ricciardi R et al.. “Collagen-binding probe PET/MR for distinguishing fibrotic from inflammatory strictures in Crohn's disease.” European journal of nuclear medicine and molecular imaging (2026). PMID: 41699282 ↗
L4Cited in: Supportive Care and Complication Management
[149]
Morais TC, Couto G, da Silva BC et al.. “Psychological and hematological factors associated with fatigue in patients with Crohn's disease receiving pharmacological treatment.” World journal of gastroenterology (2026). PMID: 41693975 ↗
L3bCited in: Supportive Care and Complication Management
[150]
Mahadevan U, Seow CH, Barnes EL et al.. “Global Consensus Statement on the Management of Pregnancy in Inflammatory Bowel Disease.” Journal of Crohn's & colitis (2025). PMID: 40914850 ↗
L1cCited in: Special Populations
[151]
Mahadevan U, Seow CH, Barnes EL et al.. “Global consensus statement on the management of pregnancy in inflammatory bowel disease.” Gut (2026). PMID: 40876906 ↗
L1cCited in: Special Populations
[152]
Mahadevan U, Seow CH, Barnes EL et al.. “Global Consensus Statement on the Management of Pregnancy in Inflammatory Bowel Disease.” Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association (2025). PMID: 40874901 ↗
L1cCited in: Special Populations
[153]
Mahadevan U, Seow CH, Barnes EL et al.. “Global Consensus Statement on the Management of Pregnancy in Inflammatory Bowel Disease.” Alimentary pharmacology & therapeutics (2025). PMID: 40874657 ↗
L1cCited in: Special Populations
[154]
Mahadevan U, Seow CH, Barnes EL et al.. “Global Consensus Statement on the Management of Pregnancy in Inflammatory Bowel Disease.” Inflammatory bowel diseases (2025). PMID: 40874613 ↗
L1cCited in: Special Populations
[155]
Mahadevan U, Seow CH, Barnes EL et al.. “Global Consensus Statement on the Management of Pregnancy in Inflammatory Bowel Disease.” The American journal of gastroenterology (2025). PMID: 40862489 ↗
L1cCited in: Special Populations
[156]
Zurbuch E, Mahadevan U, Shah S et al.. “Previous Abdominal Surgery Is Not Associated With Adverse Pregnancy, Delivery, or Neonatal Outcomes in Women With Crohn's Disease: Results From the Pregnancy in Inflammatory Bowel Disease and Neonatal Outcomes Study.” The American journal of gastroenterology (2026). PMID: 41670209 ↗
L2bCited in: Special Populations
[157]
Goksu M, Karadeniz O, Orler A et al.. “Enhancing Crohn's disease management during pregnancy: innovations in therapeutic approaches and cutting-edge monitoring practices.” BMC pregnancy and childbirth (2025). PMID: 41102729 ↗
L2bCited in: Special Populations
[158]
Chambers CD, Johnson DL, Luo Y et al.. “Birth Outcomes in Women Who Have Taken Vedolizumab in Pregnancy: Results From the Vedolizumab Pregnancy Exposure Registry.” The American journal of gastroenterology (2025). PMID: 40498121 ↗
L2bCited in: Special Populations
[159]
Wieringa JW, Esser MJ, den Hartog G et al.. “Impact of immunomodulating medication on maternal Tdap vaccination-induced antibodies in infants.” Journal of Crohn's & colitis (2025). PMID: 40452230 ↗
L2bCited in: Special Populations
[160]
Prentice RE, Cho SX, Bell SJ et al.. “Innate and Adaptive Immunity is not Impacted by Inflammatory Bowel Disease Medications in Pregnant Women and Their Offspring.” Inflammatory bowel diseases (2025). PMID: 40349212 ↗
L4Cited in: Special Populations
[161]
Gilboa I, Gabbai D, Segal N et al.. “Inflammatory bowel disease and risk of perineal injury in primiparous vaginal births: a retrospective cohort study.” Inflammatory bowel diseases (2026). PMID: 42035293 ↗
L3bCited in: Special Populations