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Medicina
Special Issues
Diagnosis and Treatment of Inflammatory Bowel Disease
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Diagnosis and Treatment of Inflammatory Bowel Disease

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

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 10835

Special Issue Editor

Dr. Carmen Monica Preda

E-Mail Website
Guest Editor
1. Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
2. Department of Gastroenterology, Fundeni Clinic Institute, 022328 Bucharest, Romania
Interests: ulcerative colitis; Crohn’s disease; inflammatory bowel diseases; endoscopy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Though inflammatory bowel diseases (IBDs) have affected humans since time immemorial, they were described for the first time only in 1859, when Sir Samuel Wills used this term in a case report on ulcerative colitis. Then, in 1932, Crohn, Ginzburg and Oppenheimer published a series of 14 cases with "regional ileitis", which further contributed to the recognition of IBD as a common, and sometimes severe, disease impacting human health.

At present, several scientific societies, such as the European Crohn's and Colitis Organization (ECCO) and the Crohn's and Colitis Foundations of America (ccfa.org) and Canada (ccfc.ca) regularly publish guidelines on IBD diagnosis and treatment; however, the rapid development of new diagnostic and patient monitoring techniques and novel therapeutic possibilities (especially treatment with new biological agents), necessitates the publication of a Special Issue dedicated solely to IBDs.

Therefore, this Special Issue, ‘Diagnosis and Therapy of Inflammatory Bowel Diseases’ invites researchers, clinicians and administrators to submit their original articles, reviews, as well as case reports that describe novel diagnostic methods of IBD, propose algorithms for monitoring patients with IBD, highlights new data on the indications and sequencing of biological treatment in IBD, underscore the current indications of surgical treatment and the types of operations, and address a new treatment method in IBD, that is, diet therapy.

Potential topics include the following areas:

  1. Endoscopy in inflammatory bowel diseases, from diagnosis to treatment;
  2. Histopathologic diagnosis of inflammatory bowel diseases;
  3. Novel elements in differential diagnosis of inflammatory bowel diseases;
  4. Therapeutic monitoring of inflammatory bowel diseases;
  5. Therapy of moderate to severe Crohn’s disease;
  6. Therapy of moderate to severe ulcerative colitis;
  7. Diagnosis and treatment of pouchitis;
  8. Treatment of post-operative recurrence of Crohn’s disease;
  9. Role of diet therapy in maintaining remission of inflammatory bowel diseases in adults;
  10. Role of diet therapy in induction of remission of inflammatory bowel diseases in adults;
  11. Real-life data on the efficacy and safety of ustekinumab in Crohn’s disease in Romania;
  12. Case reports and literature reviews on paradoxical psoriasis in ustekinumab therapy.

Dr. Carmen Monica Preda
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 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
  •  inflammatory bowel diseases
  •  endoscopy
  •  histopathology
  •  therapeutic monitoring
  •  biologics
  •  infliximab
  •  adalimumab
  •  ustekinumab
  •  vedolizumab
  •  tofacitinib
  •  diets

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Published Papers (4 papers)

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Research

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9 pages, 303 KiB  
Article
Reclassification of Inflammatory Bowel Disease Type Unclassified by Small Bowel Capsule Endoscopy
by Ana-Maria Singeap, Catalin Sfarti, Irina Girleanu, Laura Huiban, Cristina Muzica, Sergiu Timofeiov, Carol Stanciu and Anca Trifan
Medicina 2023, 59(12), 2064; https://doi.org/10.3390/medicina59122064 - 23 Nov 2023
Cited by 2 | Viewed by 1815
Abstract
Background and Objectives: Ulcerative colitis (UC) and Crohn’s disease (CD) are idiopathic inflammatory bowel diseases (IBDs) without a unique, gold standard diagnostic test. UC and Crohn’s colitis are impossible to distinguish in approximately 10% of cases. The term IBD type unclassified (IBD-U) [...] Read more.
Background and Objectives: Ulcerative colitis (UC) and Crohn’s disease (CD) are idiopathic inflammatory bowel diseases (IBDs) without a unique, gold standard diagnostic test. UC and Crohn’s colitis are impossible to distinguish in approximately 10% of cases. The term IBD type unclassified (IBD-U) is recommended for cases of chronic colitis showing overlapping endoscopic, radiological, and biopsy histological features between UC and CD, while indetermined colitis is reserved for colectomy specimens. Our aim was to assess the role of small-bowel capsule endoscopy (SBCE) in the diagnostic work-up of IBD-U. Materials and Methods: We retrospectively studied the cases of IBD-U explored by SBCE in a tertiary referral gastroenterology center. Patients were investigated using SBCE after contraindications were excluded. Diagnostic criteria for small bowel CD consisted in more than three ulcerations, irregular ulcers, or stenosis, and the Lewis score was used for the quantification of inflammation. The immediate impact of reclassification and outcome data was recorded over a follow-up period of more than one year. Results: Twenty-eight patients with IBD-U were examined using SBCE. Nine patients had small bowel lesions that met the diagnostic criteria for CD, resulting in a reclassification rate of 32.1%. In five of these cases, the treatment was subsequently changed. In the remaining nineteen examinations, no significant findings were observed. There were no complications associated with SBCE. Median follow-up time was 32.5 months (range 12–60). During follow-up, twelve patients were classified as having UC, and seven remained as having an unclassified type; one case of colectomy, for medically refractory UC, was recorded. Conclusions: SBCE is a useful safe tool in the work-up of IBD-U, allowing reclassification in about one third of cases, with subsequent treatment modifications. SBCE may provide a definite diagnosis, enhance the comprehension of the disease’s progression, and optimize the short- and long-term management strategy. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Inflammatory Bowel Disease)

Review

Jump to: Research

14 pages, 313 KiB  
Review
A Comprehensive Review of Dietary Approaches in Maintaining Remission of Inflammatory Bowel Diseases in Adults
by Doina Istratescu, Carmen Monica Preda, Teodora Manuc, Corina Meianu, Tudor Stroie and Mircea Diculescu
Medicina 2024, 60(7), 1068; https://doi.org/10.3390/medicina60071068 - 28 Jun 2024
Cited by 2 | Viewed by 2234
Abstract
Inflammatory bowel disease (IBD) poses significant challenges in its management, encompassing a spectrum of conditions from Crohn’s disease to ulcerative colitis. Dietary interventions have emerged as integral components of the multidisciplinary approach to IBD management, with implications ranging from disease prevention to treatment [...] Read more.
Inflammatory bowel disease (IBD) poses significant challenges in its management, encompassing a spectrum of conditions from Crohn’s disease to ulcerative colitis. Dietary interventions have emerged as integral components of the multidisciplinary approach to IBD management, with implications ranging from disease prevention to treatment of active manifestations and addressing complications such as malnutrition. While dietary interventions show promise in improving outcomes for some patients with IBD, there is no consensus in the existing literature regarding remission maintenance in those patients. Furthermore, many patients explore dietary modifications often guided by anecdotal evidence or personal experiences and this could lead to malnutrition and decreased quality of life. This comprehensive review synthesizes existing literature to elucidate the complex interplay between diet and IBD, offering insights into the efficacy and safety of various dietary modalities in maintaining disease remission. It also highlights the importance of patient education in navigating dietary choices and potential risks associated with food avoidance, including the heightened risk of micronutrient deficiencies. Furthermore, it emphasizes the pivotal role of a multidisciplinary care team comprising clinicians and dietitians in providing personalized dietary guidance tailored to individual patient needs and goals. By synthesizing the latest evidence and providing insights into both the potential benefits and risks of dietary interventions, this review could be used as a resource for healthcare professionals and patients alike in navigating the complex landscape of dietary management in IBD. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Inflammatory Bowel Disease)
15 pages, 299 KiB  
Review
Diagnosis and Medical Treatment of Acute and Chronic Idiopathic Pouchitis in Inflammatory Bowel Disease
by Corina Meianu, Tudor Stroie, Doina Istratescu, Carmen Monica Preda and Mihai Mircea Diculescu
Medicina 2024, 60(6), 979; https://doi.org/10.3390/medicina60060979 - 13 Jun 2024
Cited by 1 | Viewed by 2382 | Correction
Abstract
Despite the decreased rates in inflammatory bowel disease (IBD) colectomies due to high advances in therapeutic options, a significant number of patients still require proctocolectomy with ileal pouch-anal anastomosis (IPPA) for ulcerative colitis (UC). Pouchitis is the most common complication in these patients, [...] Read more.
Despite the decreased rates in inflammatory bowel disease (IBD) colectomies due to high advances in therapeutic options, a significant number of patients still require proctocolectomy with ileal pouch-anal anastomosis (IPPA) for ulcerative colitis (UC). Pouchitis is the most common complication in these patients, where up to 60% develop one episode of pouchitis in the first two years after UC surgery with IPAA with severe negative impact on their quality of life. Acute cases usually respond well to antibiotics, but 15% of patients will still develop a refractory disease that requires the initiation of advanced immunosuppressive therapies. For chronic idiopathic pouchitis, current recommendations suggest using the same therapeutic options as for IBD in terms of biologics and small molecules. However, the available data are limited regarding the effectiveness of different biologics or small molecules for the management of this condition, and all evidences arise from case series and small studies. Vedolizumab is the only biologic agent that has received approval for the treatment of adult patients with moderately to severely active chronic refractory pouchitis. Despite the fact that IBD treatment is rapidly evolving with the development of novel molecules, the presence of pouchitis represents an exclusion criterion in these trials. Recommendations for the approach of these conditions range from low to very low certainty of evidence, resulting from small randomized controlled trials and case series studies. The current review focuses on the therapeutic management of idiopathic pouchitis. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Inflammatory Bowel Disease)
10 pages, 1845 KiB  
Review
Paradoxical Psoriasis Induced by Ustekinumab: A Comprehensive Review and Case Report
by Andrei Ovidiu Olteanu, Artsiom Klimko, Ioana Tieranu, Olguta Anca Orzan, Cristian Valentin Toma, Elena Mirela Ionescu, Carmen Monica Preda and Cristian George Tieranu
Medicina 2024, 60(1), 106; https://doi.org/10.3390/medicina60010106 - 6 Jan 2024
Cited by 6 | Viewed by 3848 | Correction
Abstract
Ustekinumab (UST), a biologic agent targeting interleukin-12 and interleukin-23, is widely used in the management of psoriasis and Crohn’s disease. Despite its efficacy, there have been instances of paradoxical psoriasis induction or exacerbation in some patients during UST therapy. This paper offers a [...] Read more.
Ustekinumab (UST), a biologic agent targeting interleukin-12 and interleukin-23, is widely used in the management of psoriasis and Crohn’s disease. Despite its efficacy, there have been instances of paradoxical psoriasis induction or exacerbation in some patients during UST therapy. This paper offers a comprehensive review of reported cases of UST-induced paradoxical psoriasis, including a case from our clinic. We focus on a 39-year-old female patient with a history of long-standing Crohn’s disease who developed a psoriasiform rash, as confirmed by biopsy, while undergoing UST treatment. The patient’s clinical journey, from initial diagnosis through the complexities of treatment adjustments due to various complications including drug-induced lupus and the subsequent onset of psoriatic manifestations, provides insight into the challenges encountered in the clinical management of such cases. This review emphasizes the necessity for clinicians to recognize the possibility of paradoxical psoriasis in patients receiving UST treatment and calls for further research to better understand this phenomenon and devise effective management strategies. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Inflammatory Bowel Disease)
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