Towards comprehensive disease control in inflammatory bowel disease: the right treatment for the right patient

Inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis, have a major impact on patients’ daily lives. Although modern therapies can control intestinal inflammation more effectively than ever, many patients still can develop complications or experience symptoms despite being in remission. This thesis argues that “disease control” should not be limited to inflammation alone: it must also include improving quality of life, preventing complications, and identifying patients at risk of a more severe disease course early.
To achieve this, the thesis explored how disease control can be approached more comprehensively. Using a large population-based cohort, it demonstrated that microscopic features in biopsies at diagnosis can predict which patients are more likely to have an aggressive course, helping to guide early treatment decisions. The thesis also confirmed that traditional drugs such as thiopurines remain safe and effective long-term options, even in the era of newer treatments. Furthermore, it introduced a validated questionnaire that allows systematic monitoring of infections, enabling better treatment tailoring and prevention strategies. Finally, it highlighted the burden of persistent abdominal symptoms in remission and offered practical guidance for their management.
Together, these findings pave the way for a more personalized and truly patient-centered approach to IBD care.