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Medicina
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New Advances in Inflammatory Bowel Disease and Diarrheal Disorders
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New Advances in Inflammatory Bowel Disease and Diarrheal Disorders

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Gastroenterology & Hepatology".

Deadline for manuscript submissions: 25 January 2027 | Viewed by 2687

Special Issue Editors

Prof. Dr. Ion Rogoveanu

E-Mail Website
Guest Editor
Gastroenterology Department, University of Medicine and Pharmacy Craiova, Petru Rares Street No 2-4, 200349 Craiova, Romania
Interests: gastroenterology; hepatology
Special Issues, Collections and Topics in MDPI journals
Dr. Sergiu Marian Cazacu

E-Mail Website
Guest Editor Assistant
Gastroenterology Department, University of Medicine and Pharmacy Craiova, Petru Rares Street No 2-4, 200349 Craiova, Romania
Interests: gastroenterology; internal medicine; endoscopes; endoscopic surgery

Special Issue Information

Dear Colleagues,

Recent decades have seen a significant increase in the global prevalence of inflammatory bowel diseases. The steady developments in the performance of imaging techniques, as well as the emergence of new therapeutic targets and molecules with higher treatment efficiency, have led to continuous improvements in the prognosis of patients with inflammatory bowel diseases with a significant increase in their quality of life. However, substantial progress is still needed for adequate control of the disease. As most chronic inflammatory bowel diseases have evolved over decades, the malignant potential of severe and extended forms must be taken into account, especially in poorly controlled cases, where significant mucosal changes may render the recognition of early abnormalities such as dysplasia or early carcinoma difficult.

The possibility of other potential causes of diarrhea, especially celiac disease or infectious colitis, must always be considered. Atypical forms of celiac diseases, especially the sero-negative type and the non-celiac villous atrophy, represent underrecognized entities in patients with chronic diarrhea. Infectious colitis, such as Clostridium difficile infection, Yersinia, or cytomegalovirus colitis, as well as intestinal tuberculosis in some geographic areas, may impact the evolution of inflammatory bowel diseases or pose significant problems for their diagnosis. Evolving microbial resistance to antibiotics, noted over recent years, may represent an important obstacle in the management plan of infectious colitis.

Prof. Dr. Ion Rogoveanu
Guest Editor

Dr. Sergiu Marian Cazacu
Guest Editor Assistant

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 250 words) can be sent to the Editorial Office for assessment.

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. Medicina is an international peer-reviewed open access monthly 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 2200 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

  • ulcerative colitis
  • Crohn’s disease
  • Clostridium difficile
  • celiac disease
  • cytomegalovirus colitis
  • Yersinia colitis
  • intestinal tuberculosis
  • villous atrophy

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Published Papers (3 papers)

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Research

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26 pages, 398 KB  
Article
Biologic Therapy and Surgical Management in Crohn’s Disease: Postoperative Outcomes and Biologic Management Patterns in a Retrospective Cohort Study
by Constantin-Alexandru Petraru, Tudor Stroie, Doina Istratescu, Dan Pitigoi, Corina Gabriela Meianu, Rucsandra Ilinca-Diculescu and Mircea Diculescu
Medicina 2026, 62(5), 917; https://doi.org/10.3390/medicina62050917 - 8 May 2026
Viewed by 517
Abstract
Background and Objectives: The therapeutic role of surgery in Crohn’s disease has evolved in the era of advanced biologic therapies, particularly in patients with complex and treatment-refractory disease. This study aimed to evaluate the relationship between preoperative biologic exposure and surgical outcomes, [...] Read more.
Background and Objectives: The therapeutic role of surgery in Crohn’s disease has evolved in the era of advanced biologic therapies, particularly in patients with complex and treatment-refractory disease. This study aimed to evaluate the relationship between preoperative biologic exposure and surgical outcomes, with a focus on predictors of more extensive surgical procedures, postoperative biological response, and postoperative biologic management. Materials and Methods: We conducted a retrospective cohort study including 60 patients with Crohn’s disease who underwent CD-related surgical interventions between January 2011 and December 2024. Clinical, surgical, and therapeutic data were collected. Combined resection procedures were defined as intestinal resections associated with additional surgical interventions. Postoperative biological response was defined as an exploratory composite endpoint reflecting the simultaneous normalization of hemoglobin, serum albumin, and C-reactive protein at six months. Statistical analyses, including univariable and multivariable methods, were performed. Results: Combined resection procedures were associated with advanced disease, particularly penetrating phenotypes and intra-abdominal sepsis, and with more frequent postoperative biologic intensification (OR 5.56, 95% CI: 1.05–29.57, p = 0.044). Postoperative biologic management included maintenance and intensification strategies (initiation or switching of biologic therapy). At six months, postoperative biological response was achieved in 20.7% of patients (12/58). No significant associations were observed between biological response and preoperative anti-TNF exposure or postoperative biologic intensification. Despite the relatively low rate of complete biological normalization, hemoglobin and albumin normalization were observed in 79.3% and 69.0% of patients, respectively, while the median fecal calprotectin decreased from 820 µg/g preoperatively to 130 µg/g at follow-up. Endoscopic remission was observed in 47.6% of patients with available SES-CD assessment. Conclusions: In patients with complex Crohn’s disease, surgical intervention remains an essential component of multidisciplinary management. While complete postoperative biological normalization was achieved in a limited proportion of patients, surgery was associated with consistent improvements in inflammatory and nutritional parameters. Further prospective studies are needed to better define predictors of postoperative recovery and to clarify the role of surgery within modern treatment algorithms. Full article
(This article belongs to the Special Issue New Advances in Inflammatory Bowel Disease and Diarrheal Disorders)
16 pages, 1170 KB  
Article
A Comparative Study of Different Biological Drugs in First-Line Therapy in Crohn’s Disease: A Multicenter Descriptive Analysis
by Andrei Gila, Carmen Monica Preda, Mircea Diculescu, Razvan Matei Bratu, Doina Istratescu, Tudor Stroie, Anca Trifan, Alina Tantau, Sandica Bucurica, Cristian George Tieranu, Horia Minea, Ana Maria Buzuleac, Lucian Negreanu, Remus Popescu and Cosmin Alexandru Ciora
Medicina 2026, 62(5), 901; https://doi.org/10.3390/medicina62050901 - 7 May 2026
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Abstract
Background and Objectives: Biologic agents have emerged as the most important therapeutic weapon in the treatment of Crohn’s disease (CD). The aim of this study is to describe the population of patients who received different molecules as first-line therapy and their persistence on [...] Read more.
Background and Objectives: Biologic agents have emerged as the most important therapeutic weapon in the treatment of Crohn’s disease (CD). The aim of this study is to describe the population of patients who received different molecules as first-line therapy and their persistence on first-line therapy. Materials and Methods: 622 patients from six gastroenterology departments from Bucharest, Iasi and Cluj treated between 2006 and 2024 were included in the study. A total of 87 (14%) were excluded because they received only mesalazine. A total of 535 were included in the final analysis. The main outcomes were clinical response and remission at 12 weeks of treatment and serious adverse events. Results: Three groups of patients were identified based on the first-line treatment: 45% of patients received adalimumab, 40% were treated with infliximab, and in 12.6% ustekinumab was given. Regarding the clinical and demographic characteristics, there are significant differences among the three patient groups in terms of age, disease extent, disease phenotype, proportion of individuals with perianal fistulas, clinical severity and the proportion of patients who underwent surgery. Median therapy duration was 48 months (6 ÷ 330). The three biologics studied (adalimumab, infliximab and ustekinumab) had a similar rate of clinical remission of 80%, the non-response rate also being similar (6.5%), but persistence on therapy at 2 years was better for adalimumab (66%) and infliximab (60%) compared to ustekinumab (45%) (p = 0.06). Serious adverse events leading to therapy discontinuation were more frequent in those treated with infliximab (10%) compared to adalimumab (3%) and ustekinumab (6%) (p = NS). Conclusions: There were significant baseline differences between the treatment groups, so this study represents an unadjusted comparison between the results obtained with different biologics in first-line treatment for Crohn’s disease. All three biological agents used in real life for Crohn’s disease therapy show similar efficacy, with an early clinical remission rate of approximately 80% and a non-response rate of 6.5%. Full article
(This article belongs to the Special Issue New Advances in Inflammatory Bowel Disease and Diarrheal Disorders)
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Review

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31 pages, 4715 KB  
Review
The Overlap Between Crohn’s Disease and Intestinal Tuberculosis: A Never-Ending Story
by Sergiu Marian Cazacu, Costin Teodor Streba, Cristian Constantin, Claudiu Marinel Ionele, Ion Rogoveanu, Alexandru Valentin Popescu and Mirela-Marinela Florescu
Medicina 2026, 62(4), 794; https://doi.org/10.3390/medicina62040794 - 21 Apr 2026
Viewed by 1216
Abstract
The prevalence of Crohn’s disease has increased over the last few decades, even in developing countries, whereas that of intestinal tuberculosis has decreased, which places both diseases at an epidemiological crossroads. Crohn’s disease and intestinal tuberculosis share many clinical, endoscopic, imaging, and pathological [...] Read more.
The prevalence of Crohn’s disease has increased over the last few decades, even in developing countries, whereas that of intestinal tuberculosis has decreased, which places both diseases at an epidemiological crossroads. Crohn’s disease and intestinal tuberculosis share many clinical, endoscopic, imaging, and pathological features, which sometimes make differential diagnosis very difficult; an accurate diagnosis is, however, very important since an erroneous treatment can worsen the evolution or delay proper therapy. The association between past TB infection and Crohn’s disease can make the diagnosis especially hard. This review summarizes current data on specific features that allow differentiation between Crohn’s disease and intestinal tuberculosis, paying particular attention to the microbiome, clinical signs, endoscopy, cross-sectional imaging, bacteriological, and immunological findings detailed. The importance of computerized models and scores for the differentiation is also detailed, because common features may make the differentiation based on a single criterion difficult. Full article
(This article belongs to the Special Issue New Advances in Inflammatory Bowel Disease and Diarrheal Disorders)
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