Gastrointestinal Behçet's disease: a review.

Area of Science:

• Rheumatology and Gastroenterology
• Vascular Inflammation and Systemic Autoimmune Diseases

Background:

• Behçet's disease (BD) is a chronic, multisystemic vasculitis with variable prevalence globally.
• Gastrointestinal involvement in BD significantly increases morbidity and mortality.
• Current diagnostic and monitoring methods for BD are imperfect, lacking definitive biomarkers.

Purpose of the Study:

• To review the epidemiology, clinical manifestations, diagnosis, and management of gastrointestinal Behçet's disease.
• To highlight the challenges in monitoring disease activity and the lack of evidence-based treatment strategies.
• To discuss current therapeutic options and the need for improved patient stratification and treatment approaches.

Main Methods:

• Literature review of epidemiological data, clinical features, diagnostic criteria, and treatment modalities for gastrointestinal BD.
• Analysis of current therapeutic strategies including 5-aminosalicylic acid, corticosteroids, immunomodulators, and anti-TNF therapy.
• Discussion of the limitations in disease monitoring and the unmet needs in managing severe BD cases.

Main Results:

• Gastrointestinal BD can affect any part of the digestive tract, with ileocecal involvement being most common.
• Diagnosis relies on clinical criteria, as no specific laboratory tests exist.
• Various medications are used, and surgery is reserved for refractory cases, but optimal treatment strategies remain unclear.

Conclusions:

• Gastrointestinal manifestations of BD pose significant health risks, necessitating careful management.
• There is a critical need for improved diagnostic tools, disease monitoring methods, and evidence-based treatment guidelines for BD.
• Identifying patients with a poor prognosis and tailoring treatment remain key challenges in managing this complex condition.