TOPLINE:

Patients with inflammatory bowel disease (IBD) who developed gastrointestinal (GI) infections were at a higher risk for disease flares within 1-6 months and more often required intensified medications than those who did not develop infections. Patients with ulcerative colitis (UC) experienced more hospitalisations than those with Crohn's disease.

METHODOLOGY:

• Researchers conducted this retrospective observational study at a hospital in Finland between January 2008 and June 2023 to assess potential risk factors that could predict the severity and outcomes of GI infections in patients with IBD.
• The analysis included 123 adult patients with IBD (79 with UC; mean age, 40.5 years; 52% men and 44 with Crohn's disease; mean age, 42.1 years; 57% men) who tested positive for Campylobacter spp, Yersinia spp, Salmonella spp, or enterohaemorrhagic Escherichia coli. These patients were matched with those with IBD without the infection.
• The diagnosis of IBD was confirmed via endoscopy — revealing visible abnormalities and biopsy-confirmed microscopic changes — supported by biomarkers like elevated faecal calprotectin levels.
• Data on patient characteristics, symptoms, and treatment outcomes were collected, with follow-up until 6 months post-infection to monitor IBD activity and treatment changes.

TAKEAWAY:

• Patients with IBD who developed GI infections were significantly more likely to experience a disease flare within 1-6 months (37% vs 11%; P < .001) and to require treatment intensification (37% vs 20%; P = .003) than those who did not develop GI infections.
• Patients with an IBD duration of less than 2 years had significantly higher odds of GI infections (odds ratio, 2.34; P = .029).
• Elevated C-reactive protein levels were linked to an increased risk for hospitalisation (P = .008), and patients with UC had higher rates of hospitalisation than those with Crohn's disease (P = .04).
• No significant difference was found between the use of corticosteroids, thiopurines, or biologics and hospitalisation.

IN PRACTICE:

"It is important to rule out GI bacterial infections in case of an IBD flare, as they may influence the subsequent course of the disease, requiring an escalation in medication. Patients may benefit from careful follow-up for 6 months after GI infection," the authors wrote.

SOURCE:

This study was led by Merit Kase, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. It was published online on October 22, 2025, in Therapeutic Advances in Gastroenterology.

LIMITATIONS:

The study's retrospective design and evolving diagnostic methods over time limited its findings. Unclear medication adherence and inconsistent documentation of endoscopic and biomarker-based data may have forced reliance on clinical disease activity scores alone.

DISCLOSURES:

This study did not receive any specific funding. Three authors reported receiving speaker and consultancy fees from various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.