Gastroenterology

Switching biologic class after Crohn’s surgery associates with lower endoscopic recurrence

This multicenter retrospective study included 227 biologic-exposed Crohn’s patients with ileocolonic anastomosis from nine centers. Patients either resumed the same biologic postoperatively (n=177) or switched to a different biologic not used preoperatively (n=50). Unadjusted endoscopic recurrence between 6 and 18 months was numerically lower with switching but not statistically significant (30.0% vs 40.7%). Among patients with ≤2 guideline-defined risk factors, switching significantly reduced endoscopic recurrence (20.6% vs 40.0%). 1

PPI use in IBD links to higher hospitalization and surgery rates in a national cohort

This Danish propensity-weighted cohort included 50,460 IBD patients diagnosed between 2000 and 2022. Separate PPI treatment episodes were analyzed, allowing individuals to contribute multiple exposed periods. Current PPI use was associated with increased IBD-related hospitalizations, especially in the first year after prescription (HR 1.45; later 1.16). PPI use also correlated with higher IBD-related surgery risk (HR 1.21 in year one; 1.35 thereafter). 2

“Excellent” bowel prep improves proximal serrated and SSL detection in FIT-positive screening

This single-center retrospective study analyzed 1,069 FIT-positive screening colonoscopies in adults aged 50–69. Investigators compared Boston Bowel Preparation Scale scores 8–9 (excellent) versus 6–7 (good). Excellent prep significantly increased proximal serrated polyp detection (13.7% vs 7.9%; OR 1.84, 95% CI 1.22–2.80). Sessile serrated lesion detection also improved (7.6% vs 4.0%; OR 2.00, 95% CI 1.14–3.52), with BBPS 9 outperforming 8. 3