Diagnosis of Crohn disease and Ulcerative Colitis is not always easy in biopsy specimens. In this presentation the main features of these diseases are summarized. It is highlighted the importance of multidisciplinary approach and clinical information  to classify lesions and to optimize patient management.

Educational objectives:
- to identify the main pathological features of IBD.
- to interpretate the specimen considering clinical-endoscopic information.

To understand the key steps important in optimal macroscopic assessment of IBD specimens 

To understand that the priorities of patients may may change and are different to the priorities of physicians.

1. to have an overview over the incidence of proctectomy and perineal sinus in CD
2. to see the evidence on how perineal sinus may be prevented after proctectomy in CD
3. to see the evidence on the surgical treatment of a perineal sinus in CD
4. to understand one possible algorithm of treating a perineal sinus in CD

To understand the importance of perineal ultrasound in the diagnosis and follow up of Crohn's disease
To understand the technical aspects of perineal ultrasound
To understand the features of normal perineal ultrasound and of specifiec pathologies ( Fistula, abscess)

To understand the value of enhanced recovery pathways in improving patients' outcomes
To understand the key elements of succesful implementation of enhanced recovery pathways

1. To overview the current approaches for personalized nutrition in IBD
2. To discuss practical considerations when tailoring dietary recommendations to patients with IBD
2. To discuss challenges and future directions

To emphasize the potential for integration of treatment algorithms with prediction tools in IBD for the personalization of care
To recognize how current algorithms and prediction tools can be used to select biologics in IBD

Educational objectives:
1. To understand the growing prevalence of IBD in older people.
2. To understand the specific challenges in older patients relating to co-morbidities, polypharmacy and the limited data to guide care.
3. To understand the vulnerability of older patients to the effects of corticosteroids.
4. To discuss immunomodulators, biologics (and surgery) as options in the older IBD patient.
5. To consider carefully an individual's risk of infection, malignancy and their overall fitness in decision-making.

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.

To provide an overview of expanding treatment options in IBD
To provide expert opinion of how to navigate through the different therapeutic options in IBD

Educational objectives:
1. To review IBD-associated alterations in microbial composition and metabolite production, which contribute to regulation of intestinal inflammation
2. To discuss how these microbiome alterations may serve as future therapeutic targets for precision intervention

1. Overview about Precision medicine
2. Strategies to prevent disease complications: what is in the clinic already?
3. Data on precision medicine in IBD patienst aiming to prevent disease complications

Monitoring has become an essential component of up-to-date IBD patient care. Calprotectin and imaging (ultrasound, endoscopy, MRI) will be discussed as precision monitoring tools with their advantages and disadvantages. A practical algorithm for precision monitoring will be suggested.