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Novel Insights into the Diagnosis and Management of Inflammatory Bowel Disease (IBD)

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 25 November 2025 | Viewed by 1402

Special Issue Editor

Prof. Dr. Alina Ioana Tantau

E-Mail Website
Guest Editor
Department of Internal Medicine, 4th Medical Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
Interests: inflammatory bowel disease; pancreatic disorders; EUS; digestive endoscopy; colorectal polyps

Special Issue Information

Dear Colleagues,

We are currently confronting an increasing incidence of chronic inflammatory bowel disease (IBD). The key features of IBD comprise a combination of clinical, biochemical, radiographic, endoscopic and pathological findings. Therefore, the therapeutic management of IBD is associated with multiple objectives: rapid clinical remission, a long-term outcome, mucosal healing, deep remission, steroid-free remission, a decreased risk of complications, cancer, hospitalization and surgery, and an eventual improvement in quality of life.

In recent decades, significant advances have been made in genetic, molecular and biochemical profiling for the diagnosis and monitoring of IBD. The treat-to-target strategy has been implemented in clinical practice to enable a broad range of available treatments to optimize patient outcomes. Moreover, new drugs are in development. Despite the availability of treatments, various aspects of IBD remain to be addressed. For example, many patients do not achieve remission, and ongoing symptoms may affect patients’ quality of life and lead to an increased risk of infection.

The prediction of outcomes and patients’ response to therapy is of paramount importance in decisions regarding treatment strategies. Therefore, the prognostic factors associated with the behavior of the disease, the risk of intestinal or extraintestinal complications, the risk of cancer or surgery, and the rate of response in different therapeutic molecules are still under investigation.

We are pleased to invite you to contribute your expertise and research to this Special Issue.

This Special Issue aims to address research and perspectives regarding the latest technologies for the diagnosis and treatment of IBD. Original articles and reviews that present monitoring strategies for the prediction of outcomes and the tailoring of therapy for IBD will be included. Articles that address the concept of the brain-gut axis in IBD are also welcome, as this Special Issue aims to investigate the correlation between chronic inflammation, dysbiosis and the risk of neurological disorders in IBD. Furthermore, this Special Issue aims to investigate the efficacy of novel therapeutic drugs and the outcomes of subsequent medical interventions in patients with a loss of response to anti-tumor necrosis factor agents.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following: non-invasive biomarkers for the early diagnosis of IBD and the prediction of its behavior, the genetic or molecular biomarkers associated with prognosis and drug response, the role of abdominal ultrasounds in monitoring and tailoring therapy, the management of dysplasia and colorectal cancer in IBD, the levels of anti-TNF drug and antibodies in monitoring IBD, the gut-brain axis and dysbiosis in IBD, the risk and diagnosis of neurological disorders in IBD, and nutrition and probiotics in IBD.

I look forward to receiving your contributions.

Prof. Dr. Alina Ioana Tantau
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • inflammatory bowel disease
  • non-invasive biomarkers
  • abdominal ultrasonography
  • colonoscopy
  • biologic therapy
  • small molecules
  • mucosal healing
  • brain-gut axis
  • dysbiosis
  • colorectal dysplasia

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Published Papers (3 papers)

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Research

19 pages, 772 KiB  
Article
Two Decades of Pediatric Inflammatory Bowel Disease in North-Western Romania: Phenotypic Characteristics and Diagnostic Trends
by Georgia Valentina Tartamus (Tita), Daniela Elena Serban and Marcel Vasile Tantau
J. Clin. Med. 2025, 14(13), 4597; https://doi.org/10.3390/jcm14134597 - 28 Jun 2025
Viewed by 88
Abstract
Background/Objectives: Pediatric inflammatory bowel disease (pIBD), including Crohn’s disease (CD), ulcerative colitis (UC), and IBD-unclassified (IBD-U), exhibits unique clinical features compared to adult-onset disease. This study aimed to describe phenotypic characteristics of pIBD in the north-west region of Romania over a 21-year [...] Read more.
Background/Objectives: Pediatric inflammatory bowel disease (pIBD), including Crohn’s disease (CD), ulcerative colitis (UC), and IBD-unclassified (IBD-U), exhibits unique clinical features compared to adult-onset disease. This study aimed to describe phenotypic characteristics of pIBD in the north-west region of Romania over a 21-year period and to compare our findings with those of other studies worldwide. Methods: We conducted a retrospective study of children under 18 years of age, from the north-west region of Romania, diagnosed with pIBD between 2000 and 2020 at the Emergency Clinical Hospital for Children, Cluj-Napoca. Disease phenotype at diagnosis was established according to the Paris classification. Data were collected from the hospital records and analyzed using descriptive statistics and univariate analysis of categorical variables. A p-value < 0.05 was considered statistically significant. Results: Ninety-four patients were included (CD: 51.0%; UC: 43.6%; IBD-U: 5.4%), with a median age at diagnosis of 14 years (11–15.7). Very early-onset IBD accounted for 5.3% of cases. The likelihood of being diagnosed with CD after 10 years of age was significantly higher compared to UC (OR = 4.75, 95% CI: 1.10–29.07, p = 0.03). UC most frequently presented as pancolitis (51.2%), while CD most often involved the ileocolonic region (56.3%). Inflammatory behavior was the most common CD phenotype (69%). Upper gastrointestinal involvement was documented in 18.7% of CD cases, with detection rates increasing after 2014. Perianal disease and growth impairment were significantly associated with complicated CD behavior (p = 0.03, and p = 0.007 respectively). Our findings are broadly consistent with other published reports. Conclusions: This study provides the first detailed phenotypic characterization of pIBD in this region. Our findings reflect trends observed in other populations and underscore the importance of standardized diagnostic evaluation. Full article
(This article belongs to the Special Issue Novel Insights into the Diagnosis and Management of Inflammatory Bowel Disease (IBD))
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10 pages, 1365 KiB  
Article
Elastographic Histogram Analysis as a Non-Invasive Tool for Detecting Early Intestinal Remodeling in Experimental IBD
by Rareș Crăciun, Marcel Tanțău and Cristian Tefas
J. Clin. Med. 2025, 14(11), 3992; https://doi.org/10.3390/jcm14113992 - 5 Jun 2025
Viewed by 354
Abstract
Background/Objectives: Inflammatory bowel disease (IBD), encompassing Crohn’s disease and ulcerative colitis, is characterized by cycles of inflammation and tissue remodeling that can culminate in fibrosis. Differentiating between early inflammatory and fibrotic bowel wall changes remains a diagnostic challenge due to overlapping imaging [...] Read more.
Background/Objectives: Inflammatory bowel disease (IBD), encompassing Crohn’s disease and ulcerative colitis, is characterized by cycles of inflammation and tissue remodeling that can culminate in fibrosis. Differentiating between early inflammatory and fibrotic bowel wall changes remains a diagnostic challenge due to overlapping imaging features. This study aimed to assess the potential of elastography, specifically pixel histogram analysis, as a non-invasive method to identify acute inflammatory changes in a rat model of 2,4,6-trinitrobenzenesulfonic (TNBS)-induced colitis. Methods: Female CRL:Wi rats were randomized into control and experimental groups, with the latter receiving intracolonic TNBS to induce acute colitis. On day 7 post-induction, all animals underwent ultrasonographic and strain elastographic assessment of the distal colon using a standardized protocol. Histogram-based analysis of red, green, and blue pixel distributions was performed on elastographic video frames. Results were compared with histologic grading of inflammation and fibrosis using hematoxylin-eosin and Masson’s trichrome staining. Results: Rats with TNBS-induced colitis exhibited significant weight loss, increased bowel wall thickness (31.5% vs. controls, p < 0.01), and elevated elastographic pixel intensity across all color channels (p < 0.05). Histologically, experimental animals showed severe inflammation and early submucosal fibrosis. A strong positive correlation was found between elastographic histogram values and histologic fibrosis scores (r = 0.86, p < 0.01), confirming the technique’s diagnostic relevance. Conclusions: Elastographic pixel histogram analysis is a reproducible, non-invasive approach capable of distinguishing acute inflammatory changes and early fibrotic remodeling in experimental colitis. These findings support its potential application as a diagnostic adjunct in the early assessment and monitoring of IBD-related bowel wall changes. Full article
(This article belongs to the Special Issue Novel Insights into the Diagnosis and Management of Inflammatory Bowel Disease (IBD))
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15 pages, 1062 KiB  
Article
Brain-Gut Interplay: Cognitive Performance and Biomarker Correlations in IBD Patients
by Oliviu-Florențiu Sârb, Maria Iacobescu, Andreea-Maria Soporan, Ximena-Maria Mureșan, Adriana-Daniela Sârb, Raluca Stănciulescu, Corneliu-Daniel Leucuța and Alina-Ioana Tanțău
J. Clin. Med. 2025, 14(7), 2293; https://doi.org/10.3390/jcm14072293 - 27 Mar 2025
Viewed by 586
Abstract
Background/Objectives: Inflammatory bowel diseases (IBD), including mainly ulcerative colitis (UC) and Crohn’s disease (CD), have been associated with cognitive and psychological changes, though the mechanisms remain unclear. Methods: This prospective case-control study aimed to evaluate cognitive performance and biomarkers (homocysteine, serum amyloid [...] Read more.
Background/Objectives: Inflammatory bowel diseases (IBD), including mainly ulcerative colitis (UC) and Crohn’s disease (CD), have been associated with cognitive and psychological changes, though the mechanisms remain unclear. Methods: This prospective case-control study aimed to evaluate cognitive performance and biomarkers (homocysteine, serum amyloid A, brain-derived neurotrophic factor, and S100B protein) in IBD patients. Results: A total of 90 individuals (34 UC, 21 CD, and 35 controls) were assessed using the Montreal Cognitive Assessment (MoCA), the Memory Impairment Index (MIS), and biomarker analysis. MoCA and MIS testing showed significant differences between UC, CD, and the controls, with lower scores observed in IBD groups (p = 0.003, p = 0.015). Regarding trail-making tests, digit symbol substitution tests, and forward and backward digit spans, no significant changes were observed. No functional deficits were observed in daily activities. Biomarker analysis revealed lower brain-derived neurotrophic factor and higher serum amyloid A levels in IBD patients, correlated to MOCA and MIS scores. There were no significant differences in psychological distress between IBD patients and the controls. Subtle cognitive declines were noted across all groups during the 1-year follow-up, without any statistical significance when groups were compared. Conclusions: In conclusion, IBD patients reported lower cognitive scores compared to the controls, while no differences in depression and anxiety scores were observed. Higher BDNF levels correlated with better cognitive functioning, while higher serum amyloid A correlated with lower cognitive functioning. Full article
(This article belongs to the Special Issue Novel Insights into the Diagnosis and Management of Inflammatory Bowel Disease (IBD))
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