This review highlights the on-going need for IBD prevention and prediction and the current limitations. It is argued here that data from large cohort studies such as the GEM project, among others, support the concept that IBD has a pre-clinical period wherein biological changes occur prior to the clinical manifestation of the disease. As such, it is important that the pre-clinical period is clearly defined as it may reveal the triggers of disease that may be amenable to early intervention. Using data from pre-clinical cohorts, known risk factors, and known pre-clinical biomarkers, this review defines the 4 stages of disease initiation and progression: Stage 1 – At risk, Stage 2 – Disease initiation, Stage 3 – Disease expansion, and Stage 4- Diagnosis.
Torres J, Halfvarson J, Rodríguez-Lago I, Hedin CR, Jess T, Dubinsky M, Croitoru K, & Colombel J-F. Results of the Seventh Scientific Workshop of ECCO: Precision Medicine in IBD—Prediction and Prevention of Inflammatory Bowel Disease.
Journal of Crohn's and Colitis. 2021 Mar; 15(9): 1443–1454.
https://doi.org/10.1093/ecco-jcc/jjab048