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Inflammatory Bowel Disease III: Crohn's Disease01:25

Inflammatory Bowel Disease III: Crohn's Disease

Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...
Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

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Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
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Inflammatory Bowel Disease I: Introduction01:26

Inflammatory Bowel Disease I: Introduction

Inflammatory bowel disease is a group of chronic disorders marked by recurrent inflammation of the gastrointestinal tract due to an abnormal immune response against gut microflora. This leads to tissue damage. The two main forms are Crohn’s disease and ulcerative colitis.Crohn’s DiseaseCrohn’s disease is a relapsing inflammatory disorder that can affect any part of the GI tract, from the mouth to the anus. It involves all layers of the bowel wall (transmural) and shows “skip lesions” in which...
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Inflammatory Bowel Disease IV: Clinical Manifestations

Inflammatory bowel disease (IBD) encompasses two major chronic disorders—ulcerative colitis and Crohn’s disease—each characterized by relapsing episodes of gastrointestinal inflammation. Although they share certain clinical features, their patterns of involvement and manifestations differ in ways that aid diagnosis and guide management.Ulcerative ColitisUlcerative colitis is limited to the colon and rectum and involves continuous inflammation of the mucosal layer. The disease course is marked...
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Chronic Bowel Disorders: Introduction

Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
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Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal BarrierA...

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Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
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Published on: December 8, 2014

When Does Clostridioides difficile "Recur"? Reconcile Epidemiologic & Bedside Recurrent CDI definitions.

Sahil Khanna1, Paul Feuerstadt2, Jessica R Allegretti3

  • 1Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, 55905, USA.

The Journal of Infectious Diseases
|June 17, 2026
PubMed
Summary

Recurrent Clostridioides difficile infection (CDI) definitions vary across clinical practice, research, and surveillance. Clarifying the definition used is crucial for accurate diagnosis and treatment of recurrent CDI.

Keywords:
Clostridioides difficileepidemiologyguideline interpretationrecurrencereinfection

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Published on: December 10, 2016

Area of Science:

  • Infectious Diseases
  • Clinical Epidemiology
  • Microbiology

Background:

  • Recurrent Clostridioides difficile infection (CDI) presents diagnostic and therapeutic challenges.
  • Existing definitions conflate colonization, test of cure, and true recurrence.
  • Distinguishing relapse from reinfection is difficult without strain typing.

Purpose of the Study:

  • To propose a pragmatic approach to defining and managing recurrent CDI.
  • To emphasize the importance of explicit definition selection for clinical decision-making.

Main Methods:

  • Review of existing definitions and clinical trial operationalization of recurrent CDI.
  • Proposal of a pragmatic framework for definition selection and clinical adjudication.

Main Results:

  • Current methods for identifying recurrent CDI are inconsistent.
  • Clinical recurrence requires symptom response and exclusion of mimics.
  • Strain typing is primarily a research tool for relapse vs. reinfection.

Conclusions:

  • Explicitly state the definition of recurrence being used.
  • Align the chosen definition with the clinical or research question.
  • Adjudicate clinical recurrence before escalating therapy for recurrent CDI.