Evidence-based clinical practice guidelines for inflammatory bowel disease 2020

Area of Science:

• Gastroenterology
• Immunology
• Internal Medicine

Background:

• Inflammatory bowel disease (IBD), encompassing ulcerative colitis (UC) and Crohn's disease (CD), is increasingly prevalent in Japan.
• The exact causes of IBD are unknown but involve genetic susceptibility, environmental factors, and gut microbiota.
• IBD presents with significant heterogeneity in disease burden, necessitating personalized treatment approaches.

Purpose of the Study:

• To revise and update the 2016 Japanese guidelines for managing inflammatory bowel disease (IBD).
• To provide comprehensive, evidence-based guidance for physicians on IBD diagnosis and treatment.
• To categorize clinical questions into Background Questions (BQs), Clinical Questions (CQs), and Future Research Questions (FRQs).

Main Methods:

• Revision of existing Japanese IBD guidelines by 17 experts from the Japanese Society of Gastroenterology in 2020.
• Categorization of 69 questions into 39 BQs, 15 CQs, and 15 FRQs.
• Assessment of evidence quality using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and determination of recommendation strength via the Delphi consensus process.

Main Results:

• The revised guidelines offer updated clinical questions and recommendations for IBD management.
• Evidence quality and recommendation strength were systematically evaluated for each clinical question.
• The guideline provides practical information for physicians regarding IBD diagnosis and treatment indications.

Conclusions:

• The updated guidelines offer comprehensive, evidence-based support for physicians managing IBD patients.
• These guidelines address the heterogeneity of IBD and emphasize tailored, evidence-based interventions.
• The structured approach to questions and evidence assessment ensures clarity and applicability for clinical practice.