Volume 21, Issue 2

For nurses working in inflammatory bowel disease (IBD), professional development often extends far beyond the walls of our own hospitals or clinics. N-ECCO offers an opportunity to connect with an international community of nurses who share the same goal: improving the quality of care for people living with IBD. Through education, research, networking, collaboration and the exchange of best practice, N-ECCO provides a platform where nurses can learn from one another while helping to shape the future of IBD nursing.

Over the years, the N-ECCO Committee has continued to develop educational formats aiming at responding to the changing needs of the IBD nursing community. From the N-ECCO School, through the structured IBD Nurse Education Programme, this evolution has now taken another important step with the ECCO Nurse IBD Curriculum Train the Trainer (ToT) Programme.

Therapeutic diets are not new to medicine. Records from St Bartholomew's Hospital in London show hospital "milk diets" and "broth diets" being prescribed centuries before dietetics existed as a formal profession [1]. Yet diet therapy for Inflammatory Bowel Disease (IBD) has been slow to follow. 1946 marked the first reported attempt to treat Ulcerative Colitis through diet (raw pork enemas), but it was not until the 1970s that exclusive enteral nutrition (EEN) emerged as an effective induction therapy for Crohn's Disease.

Every committee profits tremendously from new members who bring innovative ideas and new vigour to the group. There are always numerous highly qualified professionals suitable for this task, and it is difficult to select only one of the applicants. On this occasion we are honoured to welcome Mr Phil Tozer to S-ECCO. Phil is a highly acclaimed IBD surgeon who focuses especially on Crohn’s fistula, which is obviously still one of the most challenging areas of IBD surgery.

Growth impairment remains one of the most distinctive and clinically significant complications of paediatric Inflammatory Bowel Disease (IBD). Unlike many other disease outcomes, impaired growth can have consequences that cannot be fully reversed once the window for linear growth has closed. Importantly, growth failure is not simply a reflection of inadequate nutrition: it is an integrated marker of inflammatory burden, nutritional status, treatment exposure and disease control.

Ulcerative Colitis has traditionally been regarded as a mucosal inflammatory disorder with at most superficial submucosal ulceration and no tendency to fibrosis, in contrast to Crohn’s Disease. Yet in very early histological descriptions of UC resection specimens, a sequence of events was proposed in which acute-phase submucosal congestion and oedema evolve over time into repair by fibrosis and possibly fat infiltration, with concomitant thickening of the muscularis mucosae and perhaps the muscularis propria. In long-standing disease, the colonic lumen may become extremely narrow, and an atrop