Epidemiology, pathogenesis, diagnosis, and treatment of inflammatory bowel disease: Insights from the past two years.
10.1097/CM9.0000000000003542
- Author:
Jian WAN
1
;
Jiaming ZHOU
1
;
Zhuo WANG
1
;
Dan LIU
1
;
Hao ZHANG
1
;
Shengmao XIE
2
;
Kaichun WU
1
Author Information
1. State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi 710032, China.
2. Department of Gastroenterology, the 969th Hospital of the Joint Logistics Support Force of PLA, Huhehaote, Inner Mongolia 010051, China.
- Publication Type:Review
- Keywords:
Diagnosis;
Epidemiology;
Inflammatory bowel disease;
Pathogenesis;
Telemedicine;
Treatment
- MeSH:
Humans;
Inflammatory Bowel Diseases/therapy*
- From:
Chinese Medical Journal
2025;138(7):763-776
- CountryChina
- Language:English
-
Abstract:
Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease, is a chronic inflammation of the gastrointestinal tract with unknown etiology. The cause of IBD is widely considered multifactorial, with prevailing hypotheses suggesting that the microbiome and various environmental factors contribute to inappropriate activation of the mucosal immune system in genetically susceptible individuals. Although the incidence of IBD has stabilized in Western countries, it is rapidly increasing in newly industrialized countries, particularly China, making IBD a global disease. Significant changes in multiple biomarkers before IBD diagnosis during the preclinical phase provide opportunities for earlier diagnosis and intervention. Advances in technology have driven the development of telemonitoring tools, such as home-testing kits for fecal calprotectin, serum cytokines, and therapeutic drug concentrations, as well as wearable devices for testing sweat cytokines and heart rate variability. These tools enable real-time disease activity assessment and timely treatment strategy adjustments. A wide range of novel drugs for IBD, including interleukin-23 inhibitors (mirikizumab, risankizumab, and guselkumab) and small-molecule drugs (etrasimod and upadacitinib), have been introduced in the past few years. Despite these advancements, approximately one-third of patients remain primary non-responders to the initial treatment, and half eventually lose response over time. Precision medicine integrating multi-omics data, advanced combination therapy, and complementary approaches, including stem cell transplantation, psychological therapies, neuromodulation, and gut microbiome modulation therapy, may offer solutions to break through the therapeutic ceiling.
