bluuebunny/crossref_metadata_2025 huggingface dataset:
P1330 The gut microbiome at the onset of inflammatory bowel disease: A systematic review of the literature and unified bioinformatic synthesis of sequencing data from >1000 treatment naïve patients
Authors: Rimmer P , Zhang F , Scott G , Hold G , Gordon M , Iqbal T , Hansen R
Published: January 2025

Background

There are few studies of the gut microbiome in new-onset IBD. We present a novel secondary bioinformatic re-analysis (BA) of sequence outputs mapped to latest microbial taxonomy derived from systematic review.

Methods

MEDLINE and Embase searches were performed for microbiome studies in pre-treatment IBD. Appraisal was completed with ROBINS-E. Available 16S rRNA sequence datasets were downloaded and missing datasets requested. Integrated datasets were run through a unified pipeline based in QIIME2 supplemented by phyloseq and DESeq2.

Results

From 12,264 studies, 10,804 abstracts and 217 full texts were screened. 31 studies were eligible; 18 met the requirements for BA. Most were low risk for bias, except uncontrolled confounding. Methodology varied extensively. Considering only amplicon data; samples originated from 1,743 unique individuals (including 678 Crohn’s disease (CD), 399 ulcerative colitis (UC), 123 ‘other’ IBD, 130 healthy, 405 symptomatic, and 8 familial controls) derived from 15 countries. DNA was extracted using 15 different kits, sequencing performed on 4 separate platforms targeting 10 different 16S rRNA hypervariable regions. There was a paucity of adult data, particularly mucosal biopsies.

Bacterial alpha diversity was reduced: in faeces in paediatric UC vs symptomatic controls (SC), in adult CD and UC vs HC and in paediatric SC vs HC (Figure 1).

In paediatric biopsies in CD vs SC, CD vs UC, SC vs UC (Figure 2).

Beta-diversity BA by Bray-Curtis demonstrated clear distinctions between faecal and mucosal biopsy communities, least evident in UC. Faecal communities separated by geography, though less evidently in biopsies.

Differential abundance analysis revealed enrichment of oral genera across sample types (Fusobacterium, Peptostreptococcus, Neisseria in CD; Haemophilus, Aggregatibacter, Peptostreptococcus, Porphyromonas, Neisseria, Gemella in UC). Short-chain fatty acid (SCFA) producers were diminished but less consistently across IBD phenotype and sample type.

Conclusion

This work demonstrates the utility of a combined systematic review/secondary data analysis approach to published microbiome datasets. Whilst synthesis remains challenging due to the methodological inconsistencies within these studies, this approach better accounts for these variations and presents a new way to consider this data. A reduction in bacterial diversity remains core to the IBD microbiome, though with more complexity than previously considered (SC<UC in paediatric biopsies). Microbial community structure changes by sample type and geography. Enrichment of oral bacteria is consistent across IBD subtypes and sample types suggesting their importance in the disease. A deficit in SCFA producers may also be important.
P1332 Differences in gut microbiome regarding education level, occupation and income level during COVID-19
Authors: Straume Z , Krumina N , Elbere I , Rozenberga M , Blomniece L , Zidkova L , Rudzite D , Erts R , Megnis K , Krumina A
Published: January 2025

Background

Psychological and physical stress can worsen symptoms and contribute to flare-ups in ulcerative colitis (UC) patients. The education level, occupation and income level may affect ulcerative colitis patients during stressful periods such as COVID-19 outbreak.

Methods

In 12 months time (June 2021 to June 2022) 79 ulcerative colitis (UC) outpatients from Riga East Clinical University Hospital and 78 healthy controls were included in a Cross-sectional study. All patients were divided into groups according to medically proven data about COVID-19 status (COVID-19pos vs. COVID-19neg) within the last 6 months. Information about education, occupation, income level, stress, and faecal samples was collected. For taxonomical classifying of the gut microbiome shotgun-metagenome data, MetaPhlAn v.2.6.0 tool was used. Stress levels were evaluated by subjective self-assessment reporting high stress in the last month. In further analysis gut microbiome (mostly bacteria phyla) and related data were analysed with SPSS 20.0.

Results

In the UC group were 35(44.3%) female and 44(55.7%) males, in controls 63 (80.8%) female and 15(19.2%) male,p<0.001. UC group had fewer COVID-19 cases (16(20.5%) vs. 48(61.5%),p<0.001) and were sick for a shorter time (M=2.85;SD=7.10 vs. M=5.68;SD=5.22,p=0.005). UC group with COVID-19 symptoms had less Verrucomicrobia (M=0.1; SD=0.3 vs.M=0.8; SD=2.0,p=0.012). In both groups was equally high stress in the last month; no statistically significant changes were found. UC group was more worried about contracting COVID-19 than controls 29(38.7%)vs.9(11.5%),p<0.001. Evaluating occupation, respondents were in service (56(70.9%)UC vs.72(92.3%) controls,p=0.001). Evaluating education level, 38(48.1%) UC patients had a high school education level vs. 6(7.69%) in the control group p<0.001. Less respondents had a university and above university education level (37(46.8%) in the UC colitis group vs. 72(92.3%) in the control group<0.001. Regarding income level, fewer participants in the UC group considered their income as high 12(15.2%) vs.38(48.7%),p<0.001. UC group respondents considered their income as average 56(70.9%) more often than control 32(41.0%),p<0.001.

Conclusion

UC patients had COVID-19 less frequently and suffered from COVID-19 shorter time than healthy controls. Both groups underwent high stress in the last month before the interview. UC patients were worried more about contracting COVID-19 than controls. UC group had a high school education and considered their income as average. There were no differences regarding stress levels and gut microbiota in UC and healthy controls. Those in the UC group who had COVID-19 symptoms had less Verrucomicrobia.
P1341 Probing the interaction of probiotic bacterial extracellular vesicles with primary colonic epithelium using an ex-vivo organoid platform
Authors: Hentschel V , Govindarajan D , Ziermann A , Rolle-Kampczyk U , Jehmlich N , von Bergen M , Schulte S , Schäfer K H , Bökel C , Seufferlein T
Published: January 2025

Background

Bacterial extracellular vesicles (BEV) are increasingly recognized as a relevant mode of contactless host-microbiota communication. BEV are nanoparticles pinched off from the membrane of multiple bacteria and carry nucleic acid snippets and functional proteins inherited from their parental bacteria. While evidence suggests that BEV act as transmitters to modulate the immune response, only scarce data exist as to whether and how efficiently BEV are internalized by colonic epithelium as the host‘s front line in the gut. This study aims to quantify BEV internalization into primary colonic epithelium and explore structural and physicochemical properties of BEV potentially influencing uptake.

Methods

BEV were isolated from Limosilactobacillus reuteri (LR) and Lactiplantibacillus plantarum (LP) and incubated with either colonoids or colonic epithelial monolayers from C57BL/6 mice. BEV were characterized by transmission electron microscopy (TEM), nanoparticle tracking analysis (NTA), dynamic light scattering (DLS), zeta potential (ZP) analysis, as well as lipidomic and proteomic analysis. Uptake of BEV into colonic epithelium was assessed by confocal microscopy and flow cytometry.

Results

BEV of either species displayed a uniform appearance with a lipid bilayer on TEM. NTA showed similar spectra of sizes with a dominant peak around 100 nm whereas with DLS particle size readings were higher and showed a bimodal distribution. The ZP of BEV measured in buffer with physiological salinity did not differ between LR and LP. Gas chromatographic mass spectrometry analysis revealed neither qualitative nor quantitative differences in the composition of long chain fatty acid in BEV membranes. As opposed to LP, LR pellets showed proteomic enrichment of pathways linked to glycerolipid metabolism, fatty acid biosynthesis, and terpenoid backbone synthesis, being precursor steps of lipoteichoic acid synthesis (LTA). LTA could be detected in BEV of both species, but appeared to more abundant in LR-BEV. A dose-dependent increment in BEV uptake rates was noted in both species, with LR-BEV being more readily internalized by colonic epithelium. Epithelial cells exposed to LR-BEV were characterized by irregular nuclei and partial detachment from the surface whilst cells incubated with LP-BEV appeared morphologically normal. The quantity of viable cells was reduced in colonoids treated with LR-BEV, but not LP-BEV. In the presence of LR-BEV, colonoids were less likely to undergo apoptosis.

Conclusion

LR- and LP-BEV differ in their ability to enter colonic epithelium and interfere with cellular homeostasis. A variable degree of LTA decoration of BEV membranes might account for differential uptake into the host cell.
P1347 Gut Microbial DL-Endopeptidase in Crohn’s Disease: Links to Inflammation and Dietary Modulation
Authors: Zhu Z , Wu X , He X , Feng R , Zhou H , Chen M
Published: January 2025

Background

Diet and gut microbiota are pivotal in the pathogenesis of Crohn's disease (CD). DL-endopeptidases from Firmicutes can produce ligands for NOD2 receptors, facilitating the alleviation of intestinal inflammation. This study investigates how diet influences gut microbiota and intestinal inflammation, focusing on the correlation between dietary intake and the abundance of DL-endopeptidase genes, and explores potential dietary interventions.

Methods

Data were derived from the SOURCE cohort at the First Affiliated Hospital of Sun Yat-sen University, including 252 participants (47 CD patients and 205 healthy controls). Fecal metagenomic sequencing quantified three DL-endopeptidase subclasses: secreted NLPC_P60 (P60S), non-secreted NLPC_P60 (P60N), and peptidase M14 (M14). A Food Frequency Questionnaire (FFQ) assessed dietary intake across 27 nutrients. Correlations were analyzed between DL-endopeptidase gene abundance, CD clinical features, inflammatory markers, and nutrient intake.

Results

CD patients showed significantly lower abundance of all three DL-endopeptidase subclasses compared to healthy controls (P < 0.01). Among CD patients, M14 abundance was higher in remission compared to mild (P < 0.1） or moderate disease activity (P < 0.05). DL-endopeptidase abundance was not associated with disease location, behavior, upper gastrointestinal involvement, or perianal lesions (P > 0.05). Negative correlations were observed between DL-endopeptidase and inflammatory markers (WBC, platelets, ESR, CRP), while positive correlations emerged with remission markers (hemoglobin, albumin, vitamin D).

Dietary analyses revealed negative correlations between M14 and fat, red meat, and iron intake in healthy controls (P < 0.05), with similar trends for P60S and P60N. In CD patients, P60N negatively correlated with total energy intake (P < 0.05), while vitamin B12 and vitamin D positively correlated with DL-endopeptidase abundance.

Conclusion

DL-endopeptidase abundance is linked to gut inflammation and dietary patterns in CD. Dietary interventions could potentially modulate DL-endopeptidase-producing Firmicutes bacteria to mitigate inflammation. Future studies aim to validate these findings in external cohorts and animal models, offering new insights into dietary strategies as adjunct therapies for CD. This work highlights the importance of the diet-microbiota-inflammation axis in understanding and managing CD progression and prognosis.
P1354 Diagnosis of ulcerative colitis remission from the perspective of gut microbiota: when is non-invasiveness useful?
Authors: Tarasova G , Zubova A
Published: January 2025

Background

The growing global prevalence of UC (UC) necessitates continued advances in diagnostics and treatment. Numerous studies show that changes in the composition of the gut microbiota constitute an important factor influencing both the development of ulcerative colitis and the prognosis of the disease, drug metabolism and effectiveness of treatment. Gut microbiota can be considered as a promising dynamic biomarker for non-invasive assessment of the severity of UC and the effectiveness of treatment.

Methods

The study included 21 patients (age from 20 to 41 years, 13 men and 8 women) in the relapse phase of UC - left-sided UC with mild to moderate activity (Truelov-Witts scale, Mayo index); and 20 patients (age from 26 to 52 years, 10 men and 10 women) in the phase of clinical endoscopic remission. The gut microbiota was assessed by NGS sequencing of the bacterial 16S ribosomal RNA gene structure using the IlluminaMiSeq platform. After the normality test, we performed statistical analysis using the nonparametric Mann-Whitney test, the analysis is presented by median and quartiles.

Results

Statistically significant differences between the relapse and remission groups were identified for 15 genera of microorganisms. In the relapse group, higher levels of Enterococcus, Streptococcus, Granulicatella, Pelomonas, TM7x, Actinomyces, Gemella, Corynebacterium, Bradyrhizobium, and lower levels of NK4A214_group, Pseudoscardovia, Family_XIII_UCG-001, Anaerofilum, Candidatus_Soleaferrea, DNF00809 were found (tab. 1).

Data obtained demonstrates taxonomic differences at the genus level in patients in the relapse phase and in clinical and endoscopic remission of UC (fig. 1).

Conclusion

Data obtained demonstrates taxonomic differences at the genus level in patients in the relapse phase and in clinical and endoscopic remission of UC. The identified structural changes in the gut microbiota allow for implementation as a non-invasive method for monitoring the course of progression the disease.
P1357 Association between stool infection and C - reactive protein levels in Ulcerative Colitis: A retrospective analysis in Albania
Authors: Sina Dr. M , Hoxha S , Telaku S , Pemaj X , Osja E , Prifti S
Published: January 2025

Background

Stool infections complicate the management of Ulcerative Colitis (UC), worsening symptoms and treatment outcomes. This study aimed to explore the relationship between stool infections and C-reactive protein (CRP) levels, a marker of inflammation, in UC patients.

Methods

A retrospective study was conducted at the IBD Unit, Clinic of Gastroenterology, Tirana, Albania, between April and October 2024. A total of 25 active (mean total Mayo score 5.72 ±1.67) UC patients (15 females, 10 males, mean age 41.96 ± 13.99 years, disease duration 9.26 ± 11.59 years) were included. Stool samples were tested for pathogens, and CRP levels were measured. Demographic data, and treatment history (including corticosteroids, immunosuppressants, and antibiotics) were recorded. The relationship between CRP levels, stool infection status, and clinical variables was analyzed using Pearson correlation and logistic regression models. ANOVA was used to compare CRP levels between UC patients with and without stool infection.

Results

Stool infections were present in 10 of 25 patients (40%), with 6 (60%) having multiple infections. Identified pathogens included Clostridium difficile (3), Enteropathogenic E. Coli (4), Enterohemorrhagic E. Coli (1), Dientamoeba fragilis (2), Aeromonas species (2), Norovirus (2), Shiga toxin-producing bacteria (2), Salmonella (1), and Blastocystis species (1). Of the infected patients, 4 (40%) were on multiple drugs, (corticosteroid and immunosuppressant), and 1 (10%) had recent antibiotic use. The mean CRP level was significantly higher in the stool infection group (13.09 ± 13.73 mg/L vs 4.41 ± 4.75 mg/L (F = 5.163, p = 0.033). A significant correlation was seen between CRP levels and stool infection (r =0.420, p = 0.041). Logistic regression suggested that each 1-unit increase in CRP was associated with an increase of 11.5% in the odds of stool infection {Exp (B) = 1.115}, though this trend was not statistically significant (p = 0.076).

Conclusion

Stool infection is associated with higher CRP levels in UC patients, suggesting increased inflammation in the presence of infection. Although CRP levels correlate with infection status, they do not reliably predict stool infection risk in this cohort. This study highlights the common occurrence of stool infections among UC patients and the potential role of infection in disease activity, though further research is needed to clarify the predictive value of CRP and other biomarkers in UC management.
P1358 Microbiome differences in ulcerative colitis patients and healthy controls during the COVID-19 outbreak regarding dietary preferences, supplement, probiotic and antibiotic consumption history
Authors: Straume Z , Krumina N , Elbere I , Rozenberga M , Blomniece L , Zidkova L , Rudzite D , Erts R , Megnis K , Krumina A
Published: January 2025

Background

There has been much interest in the possible benefits of microbiome-modulating interventions, such as probiotics, prebiotics, antibiotics in ulcerative colitis. Microbiota plays an important role in host health and is perturbed by several factors including antibiotics and diseases like coronavirus disease 2019 (COVID-19).

Methods

From June 2021 to June 2022 79 ulcerative colitis (UC) outpatients from Riga East Clinical University Hospital and 78 healthy controls were included in a Cross-sectional study. All patients were divided into groups according to medically proven data about COVID-19 status (COVID-19pos vs. COVID-19neg) within the last 6 months. Information about diet, vitamin, probiotic, and antibiotic intake and faecal samples were collected. MetaPhlAn v.2.6.0 tool was used for taxonomically classifying the gut microbiome shotgun-metagenome data. In further analysis gut microbiome (mostly bacteria phyla) and related data were analysed with SPSS 20.0.

Results

Overall, 157 participants were included in the study: 79 patients with ulcerative colitis and 78 healthy controls. In the UC group were 35(44.3%) female and 44(55.7%) males, in controls 63(80.8%) female and 15(19.2%) male, p<0.001.The most followed diets were lactose-free diet (8(10.5%) vs.3(3.90%), p=0.2) and gluten-free diet (4(5.19%) vs 6 (7.79%),p=0.7). Controls were more in low carb diet (3 (3.80%) vs.7(8.97%),p=0.2). Vegetarians were more in controls (1(1.27%) vs. 6(7.69%), p=0.06). There were no statistically significant differences regarding sweet consumption and gut microbiome in both groups. In the UC group fewer vitamin C users (8(10.1%) vs. 20(25.6%), p=0.02, vitamin D users 26(32.9%) vs.44(56.4%), p=0.005,vitamin B 4(5.06%) vs. 15(19.2%),p=0.01. In the UC group vitamin C users had less Euryarchaeota (M=0.0;SD=0.1 vs. M=1.0;SD=2.2,p<0.001) and fewer Proteobacteria (M=1.4;SD=1.3 vs. M=4.1;SD=7.8,p=0.11) than non-users. No Euryarchaeota were found in UC using vitamin B (M=0.0; SD+0.0 vs. M=0.9;SD=2.1,p<0.001). No statistical significance was found regarding use of antibiotics in both groups. Probiotics were used less frequently in the UC group at the time of the interview (13(16.5%) vs. 22(28.2%),p=0.1) and during the last month (13(16.5%) vs. 22(28.2%),p=0.1), no statistically significant differences were found in their gut microbiota. There were no statistically significant differences regarding the use of vitamin D and gut microbiome.

Conclusion

The most followed diets were lactose-free and gluten-free diets. There were no differences regarding sweet and vitamin D consumption and gut microbiome. In the UC group vitamin C users had less Euryarchaeota and less Proteobacteria than no users. There were no Euryarchaeota found in UC who were using vitamin B.
N11 Switching from intravenous to subcutaneous infliximab enhances trough levels and can facilitate de-escalation of concomitant immunomodulation, irrespective of the HLA DQA1*05 status: a prospective real-world study
Authors: Fitzgerald A L , McBride J , Robertson H , Turnbull J , Talbot A , Whitehead E , Sebastian S
Published: January 2025

Background

There is emerging data on the continued efficacy of infliximab when switched from intravenous (IV) to subcutaneous (SC) route in Inflammatory bowel disease (IBD). The impact of cessation of concomitant immunomodulators (IMMs) following switch on trough levels or development of anti-drug antibodies (ADAs) is not evaluated in real world practice. We aimed to study the impact of cessation of IMMs following switch of infliximab from IV to SC route and determine relationship with HLA- DQA1 *05 status.

Methods

Consecutive patients who participated in a planned switch programme were prospectively included. Clinical, biomarker and pharmacokinetic data were collected pre-switch, and at 8 weekly intervals post switch for 6 months. Trough levels and remission status in patients who discontinued or reduced the dose of IMMs were compared with those who remained or continued same dose on IMMs. All patients had HLA-DQA1*05 status determined at initiation of Infliximab and we evaluated the impact of HLA status on development of anti-Infliximab antibodies post switch.

Results

One hundred and fifteen patients (M: F=1.4:1, Median age 44 years (13-76), UC/CD (48/67) who completed 6 month follow up were included. All patients were in clinical and biomarker remission prior to the switch. 72 patients (62.6%) were on concomitant IMMs and 46 (40.86%) was HLADQA1*05 positive. The mean infliximab trough level prior to switch was 5.54 µg/mL which increased 8 weeks post switch to 12.52 µg/mL (p=0.006). The enhancement of levels persisted at 16 weeks (Mean 16.28) and at week 24 (17.25). 36 patients (32%) were positive for ADAs before switch; in 8 patients (22%) the ADAs disappeared at 8 weeks and in further 4 (total 33%) by 6 months. In total antibody titre reduced or become negative in 17 patients (48.6%), static in 14 patients (40%) but increased in 5 patients (14%) without significant lowering of trough levels. 18 of the 72 patients (25%) had IMMs discontinued, and dose reduced in further 21 patients. The total de-escalation rate was 54% and none of these patients developed ADAs at 6 months irrespective of the HLADQA1*05 status (HR = 0.76, 95% = 0.64 to 1.73, p 0.12). One patient switched back to IV due to personal preference. At 6 months none of the patients discontinued SC infliximab or were switched within or out of class.

Conclusion

Switch from IV to SC infliximab is effective in maintaining and enhancing trough levels with positive impact on reducing ADAs. It is feasible to de-escalate concomitant IMMs in a considerable proportion of patients following switch. Economic analysis of switch should be incorporated in the feasibility of IMMs withdrawal.
N12 Patient perspectives of switch in route of administration among patients established on long term intravenous Infliximab therapy
Authors: Fitzgerald A L , McBride J , Ibrahim F , Whitehead E , Sebastian S
Published: January 2025

Background

An increasing number of patients are switching from intravenous (IV) to subcutaneous (SC) formulations of biologic agents for inflammatory bowel disease (IBD). Research is needed to inform discussions about therapy choices for individual patients switching to SC route from established long term on IV therapy. This study investigates patient preferences, willingness to switch from IV to SC, and factors associated with acceptability of switch.

Methods

We administered a 6-item questionnaire ranked on Likert’s scale to patients undergoing planned switch from IV to SC Infliximab at our IBD centre. The questionnaire measured patient perspectives in the use of both formulations as well as the acceptability of the process of switching between them. In addition, the overall acceptability rating of the route of administration was measured on a visual analogue scale. Baseline characteristics and disease behaviour was recorded from electronic records. Eligibility to switch was deemed as being clinically stable based on clinicians’ assessment and on maintenance Infliximab therapy for ≥12.

Results

Eighty eight patients (M: F =1.2:1, UC=35, Crohn’s=53) of the 115 patients (76.5%) who were switched from intravenous to subcutaneous infliximab completed pre and post switch survey. Median age at switch was 32 years (range 17- 76) and median duration of intravenous therapy prior to switch was 156 weeks (IQR 81). Median follow up post switch was 25 weeks (IQR 38).

The proportion of patients strongly satisfied with their route of administration increased from 30% to 68% following SC switch. Negative impact on activities of daily living improved from 26% to 1% post switch.11% of patients reported negative financial consequences with IV route while post switch 98% reported no financial consequences. 9% and 8% were not in favour of or neutral to IV route pre-switch. Following switch 98% favoured SC route and 2% were neutral to the route of administration. Mean acceptability score post SC switch (9.5, range 8-10) was better than prior to switch (8, range 5-10) with 86/88 (97.7%) patients reporting equal or higher scores post switch.

Conclusion

Patients with IBD tend to be more likely to choose SC administration than IV infusion, but preferences and drivers of choice may vary according among individuals. These findings may assist discussions around appropriate treatment choices for each patient.
N13 Development of an interactive vaccination guide for Canadian Inflammatory Bowel Diseases nurses to use with immunosuppressed patients with IBD: Insights into the process & practical applications
Authors: Watson M , Frost K , Khalil N , Rohatinsky N , Shalhoub S
Published: January 2025

Background

Inflammatory Bowel Disease (IBD) is a chronic, immune-mediated condition requiring complex management, often with immunosuppressive therapies. These therapies increase infection risk, making vaccination vital. Given the complexities of immunosuppressive therapies and vaccine considerations, IBD nurses need support to provide vaccination-related guidance to patients. The Canadian IBD Nurses (CANIBD) group developed an interactive vaccination guide to support IBD nurses in this role and shares the process, lessons learned, and practical applications.

Methods

The interactive vaccination guide, developed by CANIBD and infectious disease specialists, is a web-based resource hosted by Crohn’s and Colitis Canada (https://canibdvaccination.ca/). With greater access to technological resources, such as computers-on-wheels and electronic tablets, the paper-based format became under-utilized. Transitioned to an interactive web-based format in 2024, the guide was redesigned to optimize usability.

The development process involved a scoping review of updates in vaccination, including COVID-19 vaccination guidelines. This review was conducted by 2 IBD nurse practitioners and 2 infectious disease specialists in pediatric and adult care. The CANIBD board members approved a budget for web development after reviewing a business proposal. The project took 12 months to complete, involving multiple virtual meetings among collaborators and web designers.

Results

The vaccination guide includes updated content on: 1) identifying immunocompromised patients; 2) live vaccines; 3) inactivated vaccines; 4) COVID-19 vaccines; 5) travel vaccines; and 6) vaccinations for family members of immunocompromised patients. Designed for ease of use, the guide enables IBD nurses to provide timely, real-time vaccination support to patients and families. It ensures appropriate and comprehensive care plans for immunocompromised patients and is regularly updated as new data emerges.

Conclusion

The vaccination guide has proven valuable for IBD care. Its interactive, question-based design simplifies vaccination recommendations, supporting patients and families in staying protected. By incorporating the latest vaccine updates and addressing family vaccination needs, the guide reduces infection risk, enhances patient care, and reinforces CANIBD’s commitment to advocacy and healthcare collaboration. Future plans include evaluating the guide’s usability and expanding its reach to other healthcare providers, such as physicians and pharmacists.
N15 Why and How To Establish Intestinal Ultrasound in the IBD Nurse Outpatient Clinic
Authors: Kühnel C , Bjerrum J
Published: January 2025

Background

Intestinal ultrasound (IUS) is an emerging, non-invasive imaging modality that has shown potential in the evaluation and management of Inflammatory Bowel Disease (IBD). As the incidence and prevalence escalate and more and more patients receive advanced biologic treatment the pressure on the outpatient clinics continues to increase. Integrating IUS in the IBD nurse outpatient clinic can potentially alleviate these challenges and improve patient care.

Objective

To outline the process of establishing IUS in the IBD nurse outpatient clinic and identify key elements to ensure successful integration.

Methods

The IBD nurse outpatient clinic for IUS was established May 2024 at Herlev Hospital, Denmark. Herlev Hospital is an international IUS training center associated with IBUS and IBUS Nordic (International Bowel Ultrasound Group). The process was initiated January 2022 during which two dedicated IBD nurses started hands-on training once a week at the center. One was subsequently internationally certified via the IBUS curriculum and exam at ECCO February 2024, and proceeded to be the primary IUS-IBD nurse upon which the clinic is based. This process was subsequently evaluated systematically by the two initial IBD nurses, two IUS trainers at the center, and two from the administration (one doctor and one nurse), and they had to reach consensus on key elements in the process.

Results

Six key elements were identified of which three were essential, i.e., education, infrastructure, and organization, see Figure. Education: IUS training and certification, preferably at an international level, is required. Infrastructure: access to a high-end ultrasound machine and dedicated room, time and personal are mandatory. Organization: support from the administration is vital. If one of these three essential key elements is missing the process will most likely be unsuccessful, meaning that no element is more important than the other.

Conclusion

Establishing IUS within the IBD nurse outpatient clinic is feasible if a few but vital elements are present, and it offers potential benefits for both patient care and organization of the IBD outpatient clinic. This initiative highlights the role of advanced nursing practice in the care of patients with IBD and supports the adoption of innovative techniques in routine clinical practice.
N19 Analysis of Decision Conflict and Decisional Regret on treatment choices in patients with Acute Severe Ulcerative Colitis
Authors: Mcbride J , Thomas M , Fitzgerald A L , Robertson H , Turnbull J , Talbot A , Thut J , Whitehead E , Sebastian S
Published: January 2025

Background

Informed choice about treatment options in the setting of Acute Severe Ulcerative Colitis (ASUC) is often challenging for the patient due to state of heightened stress in this acute setting and the ongoing uncertainties about treatment outcomes, it is uncertain whether patients reconcile with their choice made in this acute setting. We aimed to evaluate decisional conflict and decisional regret among ASUC patients and examine whether decisional conflict contributed to regret.

Methods

Patients included in a prospective observational study of ASUC filled two psychometric instruments Decisional Conflict Scale (DCS) and Decisional Regret Scale (DRS). Patients were followed up for 12 months. Differences in DCS scores between patients who underwent colectomy versus those treated with medical therapy were evaluated. Changes in DRS scores at follow up was analysed and factors resulting in high decisional regret scores were evaluated.

Results

Of the 219 patients admitted with ASUC 87 completed the DRS at 12 months. Of these, 70 had no regrets about their treatment, 11 were neutral, and 6 regretted their decision fig1. Among patients who underwent colectomy, 12 patients completed the DCS at 90 days, with 8 agreeing that it was the right decision by 12 months. For biologic treatment, 70 patients completed the DCS at 90 days, with 63 agreeing it was the right choice, and 44 patients completed the DCS at 12 months, with 43 agreeing. A subgroup of 36 patients who were unsure about their treatment choice at 90 days showed a more divided response, with 17 agreeing it was the right choice by 12 months, while 11 remained uncertain.

Conclusion

This study highlights the psychological challenges faced by ASUC patients in their treatment decisions. Decisional conflict is highly prevalent, particularly among those uncertain about their treatment options. These findings suggest the need for developing tailored decision aid tools to facilitate improved shared decision-making processes in ASUC.
N22 Exploring the Competencies of IBD Nurses in Italy: A Cross-sectional Survey
Authors: Schiavoni E , Greco D , Scaldaferri F , Napolitano D
Published: January 2025

Background

Nurses are essential for caring for patients with inflammatory bowel diseases (IBD)1. Their responsibilities encompass patient education, therapeutic management, and emotional support. However, the competencies of IBD Nurses in Italy still need to be studied2. This research assessed Italian IBD Nurses’ fundamental and advanced skills, providing a baseline for future professional development.

Methods

This cross-sectional study used an online survey developed by a multidisciplinary expert panel, including gastroenterologists and IBD nurse specialists. The 53-item survey covered sociodemographics, professional characteristics, institutional context, and competencies (fundamental and advanced) assessed via a 5-point Likert scale based on N-ECCO guidelines. Distributed nationwide from June to August 2024, descriptive statistics summarised participants' profiles, and inferential analyses, including Pearson’s correlations and ANOVA, explored associations between competencies and variables like experience, education, and institutional factors.

Results

The study analysed responses from 50 IBD Nurse, predominantly female (92%), with a mean age of 48.38 years (SD ± 9.7). Fundamental competencies showed consistently higher mean scores compared to advanced competencies. High proficiency was noted in establishing empathetic relationships and recognising the emotional impact of IBD (mean score: 4.06/5). Advanced competencies with the highest scores included caregiver education and multidisciplinary support (3.56/5 and 3.40/5, respectively). However, gaps were identified in paediatric care management (2.30/5) and transitional care (2.46/5). Significant correlations were observed between years of IBD-specific experience and competencies such as therapeutic management and stress handling.

Conclusion

Italian IBD Nurses demonstrate fundamental solid and moderate skills in advanced competencies. Gaps in paediatric and transitional care underscore the need for targeted training. Enhancing educational programs and multidisciplinary collaboration can improve the quality of care for IBD patients. Future studies should address integrating digital health tools to support self-management and patient outcomes.

References

1.McDowell C, Farooq U, Haseeb M. Inflammatory Bowel Disease. In: StatPearls. StatPearls Publishing; 2024. Accessed August 24, 2024. http://www.ncbi.nlm.nih.gov/books/NBK470312/

2.Tanaka M, Kawakami A, Sakagami K, Terai T, Ito H. Influence of multidisciplinary team care with abundant nurse staffing on patient-reported outcomes among patients with inflammatory bowel disease in clinical remission. Health Qual Life Outcomes. 2024;22(1):44. doi:10.1186/s12955-024-02247-w

3.Kemp K, Dibley L, Chauhan U, et al. Second N-ECCO Consensus Statements on the European Nursing Roles in Caring for Patients with Crohn’s Disease or Ulcerative Colitis. Journal of Crohn’s and Colitis. 2018;12(7):760-776. doi:10.1093/ecco-jcc/jjy020
N24 A longitudinal qualitative exploration of symptom clusters in new diagnosed patients with Crohn’s disease
Authors: Chen L , Zhou Y
Published: January 2025

Background

There is a burgeoning recognition that symptoms frequently coexist in ‘symptom clusters’, and comprehending these clusters may enhance the management of unrelieved symptoms in patients with Crohn’s disease. However, the nature and dynamics of the symptom clusters among newly diagnosed Chinese Crohn’s disease patients remain poorly understood.

Methods

A longitudinal qualitative study was adopted to explore the evolution of symptom clusters in newly diagnosed patients with Crohn’s disease within one year. Eighteen patients from two tertiary hospitals in southeast China were recruited through purposive sampling. Semi-structured interviews were conducted on four occasions: soon after diagnosis, 3, 6 and 12 months post-diagnosis. Data analysis of each time point was based on conventional content analysis. Afterwards, the data of each time point were compared longitudinally to capture the trend.

Results

Although some patients were unaware of the relationships among their symptoms, three clusters were identified in their narratives of individual symptoms. These symptom clusters included abdominal pain/ vomiting/ nausea/ sleep disorders (Cluster 1), diarrhea/ urgency/ bloating/ fatigue/ weight loss (Cluster 2), and anxiety/ depression/ fear/ abdominal discomfort/ loose stools (Cluster 3), all of which are shown in figure 1. As the disease duration increased, the number of patients reporting Cluster 1 decreased. Similarly, the Cluster 2 exhibited a gradual decline over time, albeit it was still the most frequently reported cluster by the participants. In addition, the occurrence of Cluster 3 did not change significantly over time.

Conclusion

Overall, the symptom cluster burden in Crohn’s disease patients gradually decreased over time, while the psychological symptoms related cluster remained stable. Due to the brain-gut axis, the psychological distress and gastrointestinal discomforts mutually influence each other, warranting additional attention. Healthcare providers ought to develop tailored interventions, aligned with the distinctive features of symptom clusters present at various stages, in order to mitigate the symptom burden and enhance the quality of life for patients diagnosed with Crohn’s disease. Furthermore, considering the limited awareness of symptom clusters among certain patients, it’s imperative to strengthen symptom related education to increase their health literacy.
N26 Factors associated with Inflammatory Bowel Disease (IBD) helpline (HL) utilisation: Crohn’s Colitis Cure Data Insight’s Program
Authors: Davidson C , Su W K , Wilson W , Rivas C , Antoniades S , Wark G , Su H , Ghaly S , Grafton R , Andrews J M , Connor S J
Published: January 2025

Background

Specialised IBD nurse-led HLs are essential to improve healthcare outcomes through the provision of timely support, proactive symptom, and disease management as well as remote medication management. This study explored patient, disease, and treatment characteristics to understand whether there are specific drivers of HL use.

Methods

Crohn’s Colitis Care (CCCare) is a cloud-based IBD-specific electronic medical record used in Australia and New Zealand. It includes a ‘HL’ tab to enable specific HL encounter documentation. De-identified data feeds into a clinical quality registry (CQR). HL-associated data prospectively entered during clinical practice from September 2023 to September 2024 were retrospectively analysed. Multivariate analysis was performed with a negative binomial regression model to investigate significant predictors influencing HL utilisation.

Results

During the 12-month period, there were a total of 10,705 contacts in a cohort of 7506 eligible people (1.4 per person (pp)), of which 8082 (75.5%) were emails and 2623 (24.5%) telephone calls. People with Crohn’s disease on average had more HL contacts than ulcerative colitis and IBDU (1.6pp vs 1.2pp vs 1.2pp respectively). See Table 1 for details.

People currently on an advanced therapy were more likely to use the HL (OR 2.3, [95% CI 0.51 to 1.13], P<0.001) compared to those who were not receiving an advanced therapy. By contrast, those residing in New Zealand were less likely to use the HL than those residing in Australia (OR 0.2, 95% CI [-2.3 to -1.0], P<0.001), as were people with composite endoscopic and radiologic remission compared to those not in remission (OR 0.8, 95% CI [-0.55 to -0.0002], P<0.05).

Conclusion

As expected, individual’s requiring complex care (on advanced therapy or not in endoscopic and radiologic remission) warrant more frequent contact with healthcare providers. A helpline bridges the gap between IBD services and the community and likely enhances positive outcomes for this population.
N27 Impact of Anaesthetic Nurse Scheduling Patterns on Resuscitation Outcomes after Painless Gastrointestinal Endoscopy in Patients with Inflammatory Bowel Disease
Authors: Hu Y , Zhu T
Published: January 2025

Background

Nurse anesthetists in the post-anesthetic care unit (PACU) of the Gastrointestinal Endoscopy Center monitor and manage complications following endoscopy procedures. We examined the impact of nurse anesthetist scheduling patterns on resuscitation efficiency of inflammatory bowel disease (IBD) patients in the anesthesia recovery room after painless gastrointestinal endoscopy.

Methods

This was a retrospective analysis of IBD patients who underwent resuscitation following painless gastrointestinal endoscopy at a large tertiary care IBD clinic. Two anesthetic nurse practitioner scheduling models were compared: In 2022 (before-reform, BR), the scheduling model consisted of three anesthetic nurse practitioners (N1, N2, N3) with a nurse-to-resuscitation bed ratio of 1.5:1. In 2023 (after-reform, AR), the scheduling template was adjusted to reduce one N2 anesthesia nurse (nurse-to-resuscitation bed ratio of 1:1). The number of consultations, length of stay, complications, anesthesia nurses' satisfaction and patient satisfaction were compared between BR and AR groups.

Results

211 and 246 patients with IBD were resuscitated in the PACU after painless gastrointestinal endoscopy in 2022 and 2023, respectively. The median length of stay in the PACU decreased significantly from 27.30 min (25.10–28.98) before the reform to 22.30 min (20.20–24.70) after the reform (p<0.001). There was no significant difference in the occurrence of complications following the implementation of the reform (hypoxemia, hypotension, nausea and vomiting, abdominal distension, pain, coughing, hypersomnia) (p=0.354). The anesthesia nurse practitioners were more satisfied with the reformed scheduling pattern, which mirrored the improved satisfaction among IBD patients.

Conclusion

The reformed anesthesia nurse scheduling model yielded improved resuscitation efficiency, reduced costs, and improved satisfaction of nurse anesthetists and IBD patients. Further studies are required to validate these findings.

References

[1].Elmunzer BJ, Anderson MA, Mishra G, Rex DK, Yadlapati R, Shaheen NJ. Quality Indicators Common to All Gastrointestinal Endoscopic Procedures. Am J Gastroenterol. 2024 .

[2].ASGE Ensuring Safety in the Gastrointestinal Endoscopy Unit Task Force, , Calderwood AH, et al. Guidelines for safety in the gastrointestinal endoscopy unit. Gastrointest Endosc. 2014. 79(3): 363-72.

[3].Luckowski A. Safety priorities in the PACU. Nursing. 2019. 49(4): 62-65.

[4].Dolinger M, Torres J, Vermeire S. Crohn's disease. Lancet. 2024. 403(10432): 1177-1191.
N38 Exploring the role of the IBD surgical link nurse in a tertiary referral centre
Authors: Baby J , Okpeh C , Sahnan K , Tozer P , Worley G , Younge L
Published: January 2025

Background

An inflammatory bowel disease (IBD) surgical link nurse (SLN) role was introduced during the Covid -19 pandemic to improve monitoring and safety netting for IBD patients awaiting surgery. Objectives include maintaining a database and working with the MDT and scheduling team to prioritise and manage operating lists, and avoid patients being removed form waiting lists inappropriately. Bi-weekly meetings facilitate MDT review with surgical, nursing, and dietetic input allowing for timely therapeutic optimisation of advanced therapies, facilitate preoperative optimisation and coordinate care among the MDT and scheduling team, often including primary and secondary care outside of our trust as appropriate. The IBD SLN also undertakes virtual clinics and provides advice line support for patients awaiting surgery providing monitoring, reassurance, education, and empowerment. We wanted to capture clinical activity and outcomes from the SLN role, including utilisation of service, by reviewing the IBD surgical monitoring database for the previous 12 months.

Methods

Three referral systems for entering the patient to the IBD surgical link nurse monitoring database were reviewed. Direct referral from colorectal surgeons, patient-initiated referrals via the existing IBD advice line service, and the IBD email service acting as a referral system for primary care, other secondary care centres, multi-disciplinary team, and advanced therapy service to highlight to the IBD SLN patients who there are concerns about. All referrals are assessed and categorised by the IBD SLN and added to the IBD surgical monitoring database.

Results

Between October 2023 to September 2024, 208 referrals were received. The majority of referrals came from colorectal surgeons. 131 virtual support sessions have been conducted for pre-operative support and education. 74 patients underwent colorectal surgeries and 4 patients declined surgery. Currently, 122 patients are on the IBD surgical monitoring database for active monitoring. Patient feedback is being collected regarding their experiences of the service.

Conclusion

The IBD SLN role supports patients while awaiting surgery. The IBD SLN acts as a support and point of access for patients and family to discuss surgery and related issues. This role has improved communication between primary care and within the MDT. The IBD surgical monitoring database strengthens safety netting and avoids unnecessary delay or cancellation in surgeries. This comprehensive monitoring system and the SLN role helps provide timely surgical care, optimises waiting lists, facilitates efficient and equitable utilisation of theatre lists, and helps to avoid unnecessary outpatient and emergency department attendance.