How to Identify High-Risk Patients in Inflammatory Bowel Disease?



Patients with inflammatory bowel disease (IBD) developing a disabling or complicated course would beneficiate of an early aggressive treatment. Identifying these patients in the early time of the disease is mandatory to use this strategy. In this article, we reviewed predictive factors according to the time during the disease course and type of IBD.

The most important clinical predictors of disease course are age at disease onset, severity of the first flare, perianal location and smoking in Crohn’s disease, very young age and disease extent in ulcerative colitis. Biological parameters such as gene polymorphisms and serologic markers are not accurate enough to guide patient treatment yet. Despite many progress, we are still not able to predict the disease course in the long term at the patient level. Thus, prediction should be given with caution to a patient. In the future, genetic and serological markers combined with other biological and clinical markers could be associated in more powerful composite predicting tools.


Crohn’s disease Ulcerative colitis Natural history Prognosis 


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© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Gastroenterology and NutritionSaint-AntoineParisFrance

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