During the recent ECCO Congress in Copenhagen, EpiCom said goodbye to Valérie Pittet and Behrooz Z. Alizadeh while Kristine Allin and Iago Rodríguez-Lago were welcomed as new Committee Members. We thank Valérie and Behrooz for their dedication to ECCO and wish them huge success in their future academic activities.

Pascal Juillerat  © ECCO

Dear ECCO Members,

What a wonderful ECCO Congress we had in Copenhagen! It was truly lovely to see everyone again at our first face-to-face Congress since 2020.

With summer just a week away, I am happy to update you all on the new and exciting content on the e-CCO Learning Platform.

In my previous letter, I mentioned the revamped, new-look platform. If you have not had the chance to explore it yet, I recommend that you take a look! 

I am happy to announce that we have introduced new content on the e-CCO Learning Platform:

Manuel Barreiro-de Acosta © ECCO

The 70^th ECCO Educational Workshop took place at the Hilton Bakirkoy Hotel in Istanbul, Turkey, on June 3, 2023. This event, the first ECCO Workshop of the year, brought together participants from Turkey and Romania and provided the perfect conclusion to the Turkish Inflammatory Bowel Disease Annual Meeting, which had started on the previous day. The workshop featured interactive discussion on various clinical scenarios and hot topics in IBD.

The primary goal of the Educational Workshops organised by the ECCO Education Committee is to harmonise IBD practices within ECCO Country Members by presenting the practical use of the ECCO Guidelines on Crohn's Disease and Ulcerative Colitis.

Torsten Kucharzik  © ECCO

Up to 50% of patients with IBD suffer from extraintestinal manifestations (EIMs), which may impact every body system. EIMs are a source of considerable morbidity, and even mortality in the case of primary sclerosing cholangitis or venous thromboembolic events. Broadly, EIMs can be categorised as those resulting from inflammatory pathology at distant sites, the consequences of IBD and treatment, or wider associations. The underlying pathophysiology of extraintestinal inflammation is not fully understood. The systemic consequences of IBD lead to broader associations, including venous thromboembolic events and anaemia. Whether these are strictly EIMs is debated, but they result in great health burdens for our patients. 

Simona Radice © ECCO

Ana Ibarra © ECCO

There are plenty of reasons why, as an Inflammatory Bowel Disease (IBD) Nurse, you should consider applying for this position, the first and foremost being to make a difference to the IBD nursing service across Europe and ultimately change the lives of patients with IBD.

Inflammatory Bowel Disease (IBD) can affect women during their reproductive years. Prenatal, perinatal and postnatal factors may be associated with adverse pregnancy outcomes and can also affect the long-term health of the infant. The perinatal period raises many concerns for the patient with IBD beyond medical therapy that can be addressed by the IBD multidisciplinary team (MDT). However, there is a lack of robust evidence on perinatal holistic management in IBD, and guidelines usually do not address non-medical and nutritional management. Therefore, D-ECCO initiated a collaborative Topical Review with the aim of assessing the scientific evidence and providing expert opinion on nutritional, psychological and supportive care for women with IBD and their infants throughout the perinatal period [1].

Pär Myrelid © ECCO

In many countries, cancer patients have had structural pathways for a number of years. Regardless of whether these are called two-week referrals, urgent referrals or cancer pathways, they have improved the care for many patients with a suspected malignancy. In a society with limited access to medical care, however, an improvement like this may come at a cost. Unfortunately, patients with chronic disease may be among those paying the price for the structural pathways within Oncology. This price comes in many different forms, but for our Inflammatory Bowel Disease patients it particularly involves prolonged waiting times for radiology, endoscopy and surgery. Thus the improvement achieved for patients with, for example, suspected colorectal cancer may at the same time represent an impairment for patients with an increased risk of developing the same type of cancer as intervals between endoscopic surveillance sessions tend to increase.

At the 18^th Congress of ECCO in Copenhagen in 2023, many exciting projects on artificial intelligence (AI) were presented. Most of these projects focused on the role of AI in endoscopy. As a pathologist, I asked myself the following question: What about the role of AI in the histological evaluation of IBD?

The pathologist plays an important role in establishing the diagnosis and in assessing therapy response. Given that in many parts of the world IBD prevalence is still rising and histological remission may soon become a treatment target, the workload for pathologists is expected to increase. Therefore, as it promises to guide and thereby reduce time spent on biopsy assessment, AI is an interesting tool for pathologists. Moreover, it may aid the mission of H-ECCO to “raise standards of IBD pathology reporting” by mitigating problems associated with inter-observer variability.

In the last decade, numerous biologics and small molecules have been tested in clinical trials for patients with Crohn’s Disease (CD), and some have already been approved and used effectively in such patients. However, there is increasing interest in the use of dietary therapies for patients with CD from both providers and patients, who often wish to start an intervention that is not associated with immunosuppression. In addition, studies in both animal models and humans have put the spotlight on different dietary components that can either provoke or suppress intestinal inflammation. As an example, specific emulsifiers that are widely used in the food industry as preservatives increase the susceptibility of mice to develop colitis [1] and also alter the faecal microbiome and metabolome in humans characterised by pro-inflammatory perturbations [2].