Magali Svrcek © ECCO

In addition to the “classical” pathway of colorectal carcinogenesis, involving development of cancer from an adenomatous precursor lesion, an alternative pathway, the serrated pathway, is now recognised to exist, and it is estimated that approximately 30% of colorectal cancers (CRC) arise via this alternative pathway [1]. In the last WHO classification, serrated polyps were classified as (i) hyperplastic polyps (HP), (ii) sessile serrated adenoma/polyps (SSA/P), with or without dysplasia, and (iii) traditional serrated adenomas (TSA). The possibility of a serrated pathway has also been suggested in colorectal carcinoma complicating Inflammatory Bowel Disease (IBD) [2–4]. Little is known concerning immunohistochemical and molecular features of serrated lesions in IBD: Data are limited to small series of patients or case reports and findings are controversial due to the rarity of the cases. However, the clinical, pathological and biological characteristics of serrated polyps in patients with IBD do seem to resemble those of their sporadic counterparts.

Lissy de Ridder © ECCO

Paediatric Inflammatory Bowel Disease (IBD) accounts for 10%–15% of all incident cases of IBD, while the incidence in children under 10 years old is rising most rapidly [1, 2]. Children and adolescents present with a more severe phenotype of disease and have both higher and unique risks (e.g. fistulising disease, growth failure, pubertal delay) and a longer disease duration, given that IBD is a lifelong disease. 

Yves Panis © ECCO

As Chair of the S-ECCO Committee, it is my pleasure to introduce two newly elected members for 2018: Christianne Buskens and Hagit Tulchinsky. Thus, as of today, the members of the S-ECCO Committee are: Antonino Spinelli (Milan, Italy; member until March 2019), Yves Panis (Clichy, France; Chair until February 2020), Michel Adamina (Winterthur, Switzerland; member until February 2020) and Christianne Buskens and Hagit Tulchinsky. Both Christianne and Hagit will stay for 3 years, until February 2021.

Rotem Sigall-Boneh © ECCO

In recent years, there has been increasing evidence that diet has an important role in Inflammatory Bowel Diseases and their management, from the pathogenesis of disease through to treatment and supportive therapy. Exclusive enteral nutrition (EEN) is a well-established dietary therapy that leads to induction of remission and also is associated with mucosal healing in patients with Crohn’s Disease (CD), especially in children. However, adherence to this therapy is low and it is difficult to maintain EEN for a long period. The mechanism by which EEN works is still elusive but several possibilities have been suggested. Accordingly, many groups have sought different dietary strategies to treat patients with CD or UC with several goals: Induction of remission, maintenance of remission and management of gastrointestinal symptoms.

Kay Greveson © ECCO

The first update of the N-ECCO Consensus Statements on the European nursing roles in caring for patients with Crohn’s Disease or Ulcerative Colitis was completed in 2018, led by one of the previous N-ECCO Chairs, Karen Kemp. 

The Consensus document focusses on the fundamental IBD nursing role and the role of the advanced Inflammatory Bowel Disease nurse, looking at factors that are more complex and need advanced IBD knowledge.

April 28, 2018

The primary goal of ECCO Educational Workshops is to harmonise IBD practices within ECCO Member Countries by presenting the practical use of the ECCO Guidelines on Crohn's Disease and Ulcerative Colitis. Additionally, these workshops provide continuous medical education with the ultimate aim of improving the quality of care for patients with IBD. ECCO Educational Workshops are aimed at individuals who are interested in IBD and provide an ideal opportunity to network whilst receiving an update on the latest ECCO Guidelines from top gastroenterologists in Europe.

Peter Irving © ECCO

Dear ECCO Friends,

The purpose of e-CCO is to improve knowledge, to enhance the educational experience and to equalise access to advanced learning opportunities in IBD for our members and throughout the world. I am pleased to be able to highlight, therefore, how the e-Learning Taskforce continues to work hard to keep the e-CCO Learning site up to date with the aim of achieving these goals.

Naila Arebi © ECCO

Collaborations are the cornerstone of research studies – from inception of the idea to execution of the project, culminating in the final research goal of generating and sharing new knowledge. Information technology has transformed the way we collaborate, opening up new avenues for collaboration through enhanced remote communication between researchers as well as easier collation and sharing of research data across centres.

The PANTS study

Nicholas Kennedy © ECCO

Use of the anti-TNF alpha monoclonal antibodies infliximab and adalimumab has transformed the management of patients with refractory Crohn’s Disease. However, clinicians and patients are all too aware that anti-TNF treatment failure is common: 10%–40% of patients fail to respond to induction therapy (referred to as primary non-response: PNR), up to 40% of patients suffer secondary loss of response in the first year of therapy and approximately 10% suffer an adverse drug reaction that curtails treatment.

In faecal microbiota transplantation (FMT) for Ulcerative Colitis, Fusobacterium is associated with lack of remission, while metabolic shifts to starch degradation and short chain fatty acid production are associated with remission (FOCUS study)

Sudarshan Paramsothy © ECCO

The randomised controlled FOCUS study [1], along with other trials [2–4], suggests that FMT is effective in the treatment of patients with active Ulcerative Colitis (UC). However, the underlying microbial basis and predictors of therapeutic outcome in UC are largely unknown. We therefore performed in-depth microbial analyses on the samples collected during the FOCUS study to help identify bacterial taxonomic and functional changes associated with FMT in UC, particularly those predictive of therapeutic success or failure.