Very Early Onset Inflammatory Bowel Disease (VEO-IBD) is a complex subset of IBD that uniquely affects children under six years of age [1]. This category includes neonatal onset (within the first month of life), infantile onset (before two years) and early childhood onset (between two and six years) [2]. In comparison with patients with older onset IBD, those with VEO-IBD demonstrate a more heterogeneous phenotype and the aetiology is more closely related (in approximately 25%–30% of cases) to monogenic or digenic defects involving genes associated with primary immunodeficiency [3]. Moreover, VEO-IBD patients show higher rates of positive family history, a more aggressive clinical trajectory and increased resistance to conventional therapies effective in managing IBD among older patients [4].

Firas Rinawi © Firas Rinawi

Primary sclerosing cholangitis (PSC) is less common in paediatrics than in adults, affecting 0.2–1.5 per 100,000 children (~20% the prevalence in adults). Those diagnosed in childhood are typically older than ten years, and there is a male predilection [1]. The aetiology of PSC is likely a multifactorial combination of an inherited predisposition, gut microbiome, gut–liver communication, bile homeostasis and downstream effects on the immune system which lead to biliary inflammation and fibrosis [2].

How do you make a surgeon? Not by the preliminaries, the 6-7 years of medical college and the years that follow in residency training, but by the six or seven years subsequently spent after medical school learning the surgical trade. Exactly what happens in this apprenticeship that transforms him\her from a helpless, frightened medical school graduate into a (hopefully) capable and confident surgeon?

Up to one-third of patients with Inflammatory Bowel Disease (IBD) have persistent bowel symptoms despite apparent control of intestinal inflammation [1]. These symptoms fit with irritable bowel syndrome (IBS), a type of disorder of gut–brain interactions (DGBI). DGBI respond poorly to the pharmacological agents that are typically used to target inflammation in IBD. Thus, as clinicians, our challenges are to identify IBS-like symptoms, which is more easily achieved in those with quiescent disease, and to find suitable treatments for control of non-inflammatory symptoms.

Wladzia Czuber-Dochan  © ECCO

Marie Andersson © ECCO

It is that time of year when we write to tell you, with great pleasure, about the N-ECCO Activities scheduled for the 19^th Congress of ECCO, to be held on February 21–24, 2024, in Stockholm, Sweden. As in previous years, the N-ECCO Committee has worked hard to put together a broad programme covering clinical, educational and research topics.

Hannah Gordon © ECCO

The second ECCO Guideline on Malignancy in IBD was published in JCC late last year, supported by working group leads Livia Biancone, Gionata Fiorino, Kostas Katsanos and Uri Kopylov. The ethos of this guideline was to couple evidence-based medicine with provision of practical advice, with a view to enhancing patient care worldwide. We worked alongside the ECCO Guidelines Team to undertake systematic reviews for each statement, selecting topics that are frequently relevant to patients with IBD as well as those which generate debate in the MDT.

Hannah Gordon © ECCO

The second ECCO Guideline on Malignancy in IBD was published in JCC late last year, supported by working group leads Livia Biancone, Gionata Fiorino, Kostas Katsanos and Uri Kopylov. The ethos of this guideline was to couple evidence-based medicine with provision of practical advice, with a view to enhancing patient care worldwide. We worked alongside the ECCO Guidelines Team to undertake systematic reviews for each statement, selecting topics that are frequently relevant to patients with IBD as well as those which generate debate in the MDT.

Firas Rinawi © Firas Rinawi

The 71^st ECCO Educational Workshop took place at The Westin Zagreb, Croatia, on June 16, 2023. This event brought together participants from Croatia, Slovenia, Serbia, Hungary, Bosnia and Herzegovina, and Italy. The workshop focused on the field of paediatric IBD and featured interactive discussions on various clinical scenarios and hot topics in paediatric IBD.

Mariangela Allocca © ECCO

Uri Kopylov © ECCO

The Educational Programme at the ECCO Congress in 2024 will once again feature two workshops focused on imaging Inflammatory Bowel Diseases (IBD). These workshops, held in collaboration with the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) and the International Bowel Ultrasound (IBUS) group, aim to educate medical professionals about the latest imaging technologies and their application in precise diagnosis and therapeutic management of IBD patients.

The first workshop will cover basic endoscopy, ultrasound and MRI, while the second will delve into advancements in intestinal ultrasound. These workshops are made possible through extensive cooperation between ECCO and experienced gastroenterologists and radiologists in intestinal imaging.

Natalia Queiroz © ECCO

The 22nd ECCO IBD Intensive Course for Trainees, Stockholm 2024

The IBD Intensive Course for Trainees will take place over one day on Wednesday, February 21, 2024, prior to the official start of the ECCO Congress. This ECCO Educational Initiative has a rich history, dating back to its conception in 2003, even before the launch of the ECCO Congress.

The fundamentals of IBD education begin during gastroenterology fellowship training. However, IBD medical education is often fragmented. The IBD Intensive Course for Trainees aims to provide advanced fellows in gastroenterology with a comprehensive understanding of IBD from a multidisciplinary perspective. In addition, the course presents a valuable opportunity for young clinicians to connect with colleagues from various countries around the globe, allowing them to explore different medical standards and establish a network for potential future collaborations. Participation in the programme is by invitation, with students nominated by ECCO National Representatives.