Inflammatory Bowel Disease: Clinical Diagnosis and Surgical Management

Dear Colleagues,

It is our pleasure to invite investigators in the areas of clinical diagnostics and surgical management of inflammatory bowel disease (IBD) to submit their work for publication in this Special Issue of Medicina, an open access MDPI journal.

Predominantly colonic Inflammatory bowel disease (IBD) encompasses ulcerative colitis (UC), and Crohn’s colitis (CC), and when the diagnostic classification for these two diseases is inconclusive, the condition is termed indeterminate colitis (IC). Here, the central medical challenge is the discrimination of IBD into specific subtypes with high accuracy because it greatly effects the surgical care of patients. Diagnostic accuracy of IC into either UC or CC is of utmost importance when determining a patient’s candidacy for pouch surgery, restorative proctocolectomy (RPC), and ileal pouch–anal anastomosis (IPAA). Further, incorrect diagnosis and treatment carry potential morbidity from inappropriate and unnecessary surgery. Studies on RPC with IPAA for UC, IC, and CC functional outcomes are encouraged.

IBD is a significant public health challenge that afflicts millions, with continually increasing prevalence worldwide. Medically, IBD has no cure. It requires lifetime symptomatic treatment and generates a financial burden of up to USD 32 billion annually within the United States alone, with a therapeutics market over USD 16 billion globally and growing at a rate of 25% per year. Conservatively, traditional treatment protocols begin with pharmaceuticals, but adverse effects make them unsuitable for long-term use, and patients may become refractory to these agents, eventually requiring surgery to control the symptoms. Thus, current medical therapies remain suboptimal for IBD treatment, and there is a significant unmet need for new therapeutics that offer better long-term prognosis and improved risk/benefit profiles. The available cutting-edge research technologies in IBD have advanced our understanding of the disease, but there are still challenges regarding diagnosis and treatment outcomes. This Special Issue (SI) on “Inflammatory Bowel Disease: Clinical Diagnosis and Surgical Management—Essential Material Needed” will present the acceptable surgical management advances and challenges in the treatment of patients suffering from IBD. This is to build a research community of authors and readers to discuss the latest research and develop new ideas and research directions on surgical treatment of IBD. Systematic analysis of authentic clinical surgery interaction is a crucial but limited element in improving quality care in IBD, and one which can be traced to the most pressing documented needs in IBD care. To make the case for the value of such work, in this SI, we provide an overview of the research on clinical surgery communication in the setting of IBD, situate that research within the existing health communication literature more generally, introduce programs of research on communication in IBD, and exemplify issues of interest emerging from the projects within programs.

Patients with medical refractory UC often undergo pouch surgery, RPC with IPAA. This intervention involves the removal of the entire colon and rectum while preserving bowel continuity, evacuation, continence/deferral, discrimination, and fertility. Long-term functional results are excellent. The challenge of diagnostic inaccuracy in colonic IBD is still a serious, unsolved problem and is associated with an increased risk of adverse outcomes, specifically CD that was not evident prior to colectomy and IC, which urgently need a solution. Recent findings in the areas of ectopic colonic ileal metaplasia and DEFA5 expansion, facilitating diagnosis of CC with accuracy, are very promising (PMID:33690604 and PMID:28817680).

Fibrostenosis, a hallmark of CD leading to stricture formation and bowel obstruction, remains a challenge in clinical management of IBD patients and represents a key event in the disease course, necessitating improved preventive strategies and multidisciplinary approach to diagnosis and management. The lack of antifibrotic therapies makes the elucidation of fibrosis mechanisms a priority, which could circumvent surgical resection. CD fibrotic strictures require endoscopic balloon dilatation and/or surgical resection. Surgical resection includes removing downstream blockage or constriction and keeping the upstream distended bowel to maintain lumina continuity, but recurrences after surgical resection are inevitable, and patients still suffer long-term bowel symptoms.

Dr. Amosy E M'Koma
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. 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 1800 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.

• inflammatory bowel disease
• clinical diagnostics
• colorectal surgery
• Crohn’s colitis
• ulcerative colitis

• Inflammatory Bowel Disease: Clinical Diagnosis and Surgical Management: 2nd Edition in Medicina (1 article)