Recent Advances in the Management of Acute Severe Ulcerative Colitis.

Acute severe ulcerative colitis is a medical emergency requiring inpatient treatment with intravenous steroids. Approximately one-third of patients do not respond to steroids sufficiently and require medical rescue therapy. Infliximab and cyclosporine are equally effective rescue agents, though infliximab is often preferred by clinicians for ease of use and greater familiarity.

Comparative Efficacy and Safety of Endoscopic Modalities for Colorectal Cancer Screening in Inflammatory Bowel Disease: A Systematic Review and Network Meta-Analysis.

Background: Long-standing Inflammatory bowel disease (IBD) increases the risk of colonic neoplasia, necessitating effective screening strategies. This network meta-analysis (NMA) compared the efficacy and safety between different endoscopic modalities in the high-definition (HD) era.

Methods: We searched CENTRAL, ClinicalTrials.

Appropriateness of small molecule agents for patients with IBD of childbearing age - a RAND/UCLA appropriateness panel.

Background: Many women of childbearing age with inflammatory bowel disease (IBD) require advanced therapies. While biologics are largely low risk during pregnancy, the novel small molecules tofacitinib, filgotinib, upadacitinib and ozanimod (TFUO) have shown concerning teratogenic effects, and decreased fertility in animal studies. Therefore, their use in women of childbearing age needs careful consideration.

Meta-Analysis: Prevalence of Frailty and Associated Adverse Events in Inflammatory Bowel Diseases.

Background: The number of adults aged over 60 years with inflammatory bowel disease (IBD) is increasing. Frailty, rather than chronological age, may be a better predictor of adverse health outcomes.

Aims: To summarise current knowledge about frailty in adults with IBD including the prevalence and associations of frailty and IBD-related adverse outcomes.

Personalisation of therapy in irritable bowel syndrome: a hypothesis.

Irritable bowel syndrome (IBS) is a common disorder of gut-brain interaction characterised by symptoms of abdominal pain, occurring at least 1 day per week, and a change in stool frequency or form. Individuals with IBS are usually subtyped according to their predominant bowel habit, which is used to direct symptom-based treatment. However, this approach is probably an oversimplification of a complex and multidimensional condition, and other factors, such as psychological health, are known to influence symptom severity and prognosis.

Dietary management of irritable bowel syndrome: considerations, challenges, and solutions.

Diet is a cornerstone in the management of irritable bowel syndrome (IBS). There is evidence of efficacy across the spectrum of dietary management strategies, including some supplements (eg, specific fibres), foods, and whole diets (eg, a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols [known as the low-FODMAP diet]). Whole-diet interventions, in particular those that restrict intake, can be challenging to deliver effectively and safely.

Considerations on Multimorbidity and Frailty in Inflammatory Bowel Diseases.

There are growing numbers of older people with inflammatory bowel diseases [IBD]. These older patients are more likely to have other comorbidities and polypharmacy, which can make recognizing and treating IBD complex. Frailty is a newer concept in the IBD field, and we are beginning to recognize the importance of this as a marker of biological age and its association with risk of adverse IBD-related outcomes.

Validating Simple Modifications to the Rome IV Criteria for the Diagnosis of Irritable Bowel Syndrome in Secondary Care.

Background: The Rome IV criteria for irritable bowel syndrome (IBS) may be too restrictive for clinical practice and research.

Aims: To validate the Rome IV criteria and study the diagnostic performance of simple modifications to them.

Methods: We collected symptom data from consecutive adults with suspected IBS seen in a single clinic.

Defining mucosal healing in randomized controlled trials of inflammatory bowel disease: A systematic review and future perspective.

Background: Mucosal healing (MH) is an established treatment goal in inflammatory bowel disease (IBD). However, various definitions of MH exist. We aimed to identify how MH is defined in randomized controlled trials (RCTs) in ulcerative colitis (UC) and Crohn's disease (CD).

Review article: The role of the gut-brain axis in inflammatory bowel disease and its therapeutic implications.

Background: Treatments targeting the gut-brain axis (GBA) are effective at reducing symptom burden in irritable bowel syndrome (IBS). The prevalence of common mental disorders and IBS-type symptom reporting is significantly higher in inflammatory bowel disease (IBD) than would be expected, suggesting potential GBA effects in this setting. Manipulation of the GBA may offer novel treatment strategies in selected patients with IBD.

Harms with placebo in trials of biological therapies and small molecules as maintenance therapy in inflammatory bowel disease: a systematic review and meta-analysis.

Background: Randomised placebo-controlled trials for the induction of inflammatory bowel disease (IBD) remission involve potential harms to those receiving placebo. Whether these harms are also apparent with placebo during maintenance of remission trials in IBD is unclear. We aimed to examine the potential harms associated with receiving placebo in trials of licensed biologics and small molecules for maintenance of remission of ulcerative colitis and luminal Crohn's disease in a meta-analysis.

Harms with placebo in trials of biological therapies and small molecules as induction therapy in inflammatory bowel disease: a systematic review and meta-analysis.

Background: Randomised placebo-controlled trials are the gold standard to assess novel drugs in ulcerative colitis and Crohn's disease. However, there might be risks associated with receiving placebo. We aimed to examine the harms associated with receiving placebo in trials of licensed biologics and small molecules for the induction of remission in ulcerative colitis and luminal Crohn's disease in a meta-analysis.

Differences in the Adverse Event Burden of Corticosteroid Use in Inflammatory Bowel Disease as Reported Between Adverse Event Reporting Systems and a Patient Questionnaire.

Background And Aims: Corticosteroids are widely used in managing inflammatory bowel disease [IBD]. While adverse events [AEs] of corticosteroids are well recognised, current understanding of corticosteroid-related AE burden in IBD remains incomplete.

Methods: AE reports for prednisone/prednisolone and budesonide were extracted from the Food and Drug Administration Adverse Event Reporting System [FAERS] and VigiBase databases.

Current Status, Challenges, and Future Directions in Crohn's Disease.

The treatment goal for patients with Crohn's disease (CD) has traditionally been aimed at symptomatic steroid-free clinical remission [...

Low-dose amitriptyline for irritable bowel syndrome (IBS): a qualitative study of patients' and GPs' views and experiences.

Background: Irritable bowel syndrome (IBS) can cause troublesome symptoms impacting patients' quality of life and incur considerable health service resource use. Guidelines suggest low-dose amitriptyline for IBS as second line treatment, but this is rarely prescribed in primary care.

Aim: To explore patients' and general practitioners' (GPs) views and experiences of using low-dose amitriptyline for IBS.

Prevalence of Sexual Dysfunction In Inflammatory Bowel Disease: Systematic Review and Meta-Analysis.

Background & Aim: Patients with inflammatory bowel disease (IBD) may experience symptoms of sexual dysfunction (SD). However, the magnitude of this problem remains uncertain. Therefore, we performed a systematic review and meta-analysis to assess the prevalence of SD in adult patients with IBD.

Novel Irritable Bowel Syndrome Subgroups are Reproducible in the Global Adult Population.

Background & Aims: Current classification systems for irritable bowel syndrome (IBS) based on bowel habit do not consider psychological impact. We validated a classification model in a UK population with confirmed IBS, using latent class analysis, incorporating psychological factors. We applied this model in the Rome Foundation Global Epidemiological Survey (RFGES), assessing impact of IBS on the individual and the health care system, and examining reproducibility.