1. appropriate assessment
2. risk factors

 In this talk we will discuss simple yet often overlooked pearls and tips to get the most of old-school medications, focusing on thiopurines and 5ASA. We will examine which combination of topical and oral 5ASA is best in each clinical scenario, discuss the role of compliance, how to optimize technical aspects of rectal agents, desensitization and factors not to be overlooked which may contribute to recalcitrant IBD. We will also explore metabolite testing for thiopurines in clinical practice and the evidence backing its use for maintenance monotherapy 

1. anti-integrins
2. p19/p40 inhibitors
3. JAK inhibitors
4. positioning biologics
5. small molecules

1. To understand proper timing of surgical indication in abdominal Crohn's disease
2. To outline that delay in surgery leads to worse outcomes
3. To delineate surgical indication in perianal CD in two phases (as adjunctive to initiation of biologics and with additional procedures if persistence of fistulas after mucosal healing of the rectum)
4. To detail proper timing of surgery in acute and chronic UC

Educational objective:
1. To understand the needs of those interested to become proficient in IBD surgery
2. To review the available resources to pursue a career in IBD surgery
2. To provide an overview of possible strategies to fill the knowledge gap

1. To review recent epidemiologic data, highlighting the importance of environmental factors
2. To understand the complexity and multiple factors contributing to IBD pathogenesis
3. To acknowledge how the complexity of IBD may affect treatment effects

Crohn’s disease is a chronic progressive inflammatory disease of the gastro-intestinal tract that may lead to bowel damage and disability. Half of patients will require surgery within ten years of diagnosis. Unfortunately, surgery is not curative, endoscopic recurrence is reported in 80% of patients within one year of diagnosis, and predicts clinical and surgical recurrence. The prevention of post-surgical recurrence is a critical target in the care of Crohn’s disease after surgery. Currently, postsurgical management and treatment of Crohn’s disease are based on endoscopic monitoring performed during the first year after surgery. However, colonoscopy is an invasive and expensive procedure, unpleasant to patients. Bowel ultrasound is a cheap, non-invasive, readily-available tool for the assessment and the monitoring of patients with inflammatory bowel disease, especially patients with Crohn’s disease. This presentation aims to review the evidence for the use of bowel ultrasound in the specific setting of postsurgical recurrence in Crohn’s disease; the diagnostic accuracy of bowel ultrasound in the detection of postsurgical recurrence in alternative to colonoscopy; its predictive value for clinical and surgical recurrence.

Clinical cases with contrast-enhanced ultrasound and elastography in Crohn's Disease strictures

Compared to the general population, patients with inflammatory bowel disease (IBD) have an increased risk of developing colorectal cancer. Chronic inflammation is believed to promote the development of neoplasia. Adenocarcinoma complicating UC and CD develops from a precursor lesion, dysplasia. Dysplasia complicating IBD is very variable macroscopically and histologically and is often multifocal. Besides conventional dysplasia in patients with IBD, nonconventional dysplasia are described. Three recent publications allow us to better define these new nonconventional types of dysplasia, from a clinical, morphological and molecular point of view, as well as nonconventional mucosal lesions in patients with IBD. Crohn’s disease (CD) is associated with an increased risk of small bowel adenocarcinoma (SBA). Research papers dedicated to small bowel adenocarcinoma (SBA) in patients with Crohn’s disease (CD) are scarce. (Yet, several advances have been accomplished in epidemiology, natural history and characteristics of SBA, in patients with CD). Several recent publications help us to better understand this entity.