More than one-third of patients with IBD are affected by extraintestinal manifestations or extraintestinal complications beyond the intestinal manifestation of the disease. The most common manifestations include arthropathies, mucocutaneous and ophthalmological manifestations, as well as conditions affecting the hepatobiliary system, both in Crohn's disease and ulcerative colitis. However, less frequent manifestations, such as pulmonary or neurological manifestations, should also be considered in patients with IBD. Several extraintestinal manifestations follow the course of the underlying intestinal activity, whereas others are independent from the intestinal inflammation. Extraintestinal complications such as iron-deficiency anaemia and osteoporosis are consequences of the intestinal disease or of disease-specific treatment. As extraintestinal manifestations and complications strongly influence quality of life, and to avoid severe complications, adequate treatment is mandatory in affected patients. We provide a comprehensive overview of different extraintestinal manifestations and complications, including their management, in patients with IBD.

In a pooled analysis of population-based studies, we found age at IBD onset to vary with sex. Further studies are needed to investigate mechanisms of sex differences in IBD incidence.

Serum collection and IBD biobank supported by the Bundesministerium für Bildung und Forschung (German Ministry of Education and Research), Kompetenznetz chronisch entzündliche Darmerkrankungen (Competence network "Inflammatory Bowel Disease"). AbstractChemerin is an adipose tissue-secreted protein that stimulates chemotaxis of cells of the innate immune system. Inflammatory bowel disease (IBD) is linked to an impaired immune response and, therefore, we hypothesized that systemic chemerin may be altered in IBDpatients. Serum was collected from patients with Crohn´s disease (CD, 230 patients), ulcerative colitis (UC, 80 patients) and healthy controls (HC, 80 probands). Chemerin and adiponectin, which has already been measured in the serum of similar cohorts by others, were determined by ELISA. Sytemic chemerin concentrations were significantly elevated in serum of CD and UC patients compared to HC, and were also found to be higher in the serum of males with CD compared to males with UC. Adiponectin levels were lower in CD compared to UC and HC with similar circulating concentrations. In serum of male but not female patients chemerin levels were higher in UC patients with active disease whereas adiponectin was reduced. In CD elevated chemerin was associated with remission in males only.Treatment with corticosteroids was linked to elevated adiponectin in male CD patients and higher chemerin in female UC patients. Unlike adiponectin that is elevated in female serum in all cohorts analysed, chemerin was only higher in the serum of female UC patients.These data indicate that the levels of circulating chemerin are elevated in patients suffering from UC and CD whereas adiponectin is reduced in the latter. Relations of the systemic 2 concentrations of these adipokines to disease activity and treatment are disease-and genderspecific.3

Background and Aims:To investigate the efficacy and safety of three different dosages of embryonated, viable eggs of Trichuris suis [TSO] versus placebo for induction of remission in mildly-to-moderately active ileocolonic, uncomplicated Crohn’s disease [CD].Methods:Adults with active CD [n = 252] randomly received six fortnightly doses of 250, 2500, or 7500 TSO/15 ml suspension/day [TSO 250, TSO 2500, TSO 7500], or 15 ml placebo solution/day, in a double-blind fashion, with 4 weeks’ follow-up. Primary endpoint was the rate of clinical remission [Crohn’s Disease Activity Index [CDAI] < 150] at end of treatment, ie at Week 12 or withdrawal. Secondary endpoints included the course of clinical remission, rate of clinical response, change in CDAI, change in markers of inflammation, mucosal healing, and Physician’s Global Assessment.Results:Clinical remission at Week 12 occurred in 38.5%, 35.2%, and 47.2% of TSO 250, TSO 2500, and TSO 7500 patients, respectively, and in 42.9% of placebo recipients. TSO induced a dose-dependent immunological response. There was no response regarding laboratory markers of inflammation. Other secondary efficacy variables also showed no advantage of TSO over placebo for treatment of active CD. Administration of TSO did not result in any serious adverse drug reaction. Review of non-serious suspected adverse drug reactions following TSO did not reveal any safety concerns.Conclusions:Administration of 250–7500 TSO fortnightly over 12 weeks was safe and showed a dose-dependent immunological response, but no TSO dose showed a clinically relevant effect over placebo for induction of clinical remission or response in mildly-to-moderately active, ileocolonic CD.

Background: Sexual function is impaired in women with inflammatory bowel disease (IBD) as compared to normal controls. We examined disease specific determinants of different aspects of low sexual function.

The incidence of the postoperative IASC is predominantly determined by preoperative disease severity. IASC have a detrimental influence on the long-term outcome following intestinal resections in patients with Crohn's disease, leading to increased number of repeat resection surgery.

Endoscopic therapy is a valuable option in the treatment of fistulae and anastomotic insufficiencies of the gastrointestinal tract. It usually is applied repeatedly. Fibrin glue is a mainstay of this procedure. Major infectious complications seem to define a subgroup of patients with poorer outcome.

Kinder und Jugendliche Fertilität Medikamente in der Schwangerschaft und Stillzeit Entbindung Impfungen des Neugeborenen Der*die ältere CED-Patient*in M. Crohn -Leitlinie AG 07 Ernährung Ernährung Ernährung als Krankheitsauslöser beim M. Crohn Ernährung als ein den Krankheitsverlauf modulierender Faktor Ernährung als therapeutischer Ansatz bei Patient*innen mit M. Crohn Ernährung zur Behandlung von Defiziten bzw. Mangelzuständen