Evaluation of Inflammatory Bowel Disease

Adam Harris, MD, Guest Editor

Edward Feller, MD, Guest Editor

The diagnosis and management of inflammatory bowel disease (IBD) is often complex. Better techniques for assessing IBD are needed. In this issue of Gastroenterology Clinics of North America , we focus on methods of diagnosing and evaluating IBD to help guide optimal treatment to maximize clinical outcomes and minimize risks. We, the guest editors, are particularly thrilled and energized to have worked with such a distinguished set of authors—highly experienced clinicians, investigators, and nationally/internationally recognized thought leaders in IBD. We asked the authors to provide a state-of-the-art update with practical information/guidelines/algorithms and cutting edge data for incorporation into practice to benefit the IBD patients we all serve.

The first set of articles deals with endoscopy: its role in diagnosis and monitoring IBD; the growing importance of chromoendoscopy in IBD surveillance exams; assessment of post-operative recurrence; and finally the emerging role of capsule endoscopy.

The second section focuses on specific scenarios that IBD physicians encounter frequently: health maintenance in IBD focusing on proper vaccinations; the growing problem of Clostridium difficile in IBD; assessment of pouch problems; optimal evaluation of perianal disease; the state of the art in using thiopurines including use of allopurinol to optimize metabolites and optimizing the use of infliximab by measuring levels and antibodies to infliximab; factors to consider in choosing monotherapy versus combination therapy and communication of risk/benefit to patients; and finally disability assessment in IBD.

The third and final section highlights noninvasive methods to evaluate IBD: clinical predictors of aggressive or disabling disease; the evolving role of specific antibodies in diagnosing, subtyping and most recently prognosticating in IBD; stool markers (calproctectin and lactoferrin) for evaluating and monitoring IBD; the growing role of imaging modalities with emphasis on MR enterography and CT enterography; and finally, the genetics of IBD and the potential role of genetic testing in the diagnosis/prognosis and tailoring of therapy.

We hope that these articles will provide clinicians with useful, state-of-the-art information in evaluating and managing IBD. Because of space restrictions, many important topics have been left out, including pregnancy in IBD and bone disease in IBD. These have been recently addressed in review articles or society guidelines. Also, we have chosen not to focus on treatment of IBD as this is recently updated in the practice guidelines published in the American Journal of Gastroenterology (and also a systematic review on medical therapies for IBD published as a supplement to the same journal). Finally, we thank our distinguished panel of authors for their time and contributions to this issue.

Elsevier’s style guide conforms to that of the AMA and Dorland’s Dictionary for possessive eponyms; this means that the term Crohn disease appears throughout the issue instead of Crohn’s disease .

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