Inflammatory bowel disease (also known with English abbreviation IBD from inflammatory bowel diseases), including Crohn's disease and ulcerative colitis, are chronic multifactorial diseases in which not only the intestines but also various organs may be affected. These manifestations are known as extraintestinal manifestations (EIM), of which skin and joint manifestations are the most frequent. Some relevant aspects of EIM are: 1) up to 25% of EIM can occur before IBD is diagnosed; 2) the diagnosis of EIM is crucial for the right choice of treatment, as not all treatments are effective for the different EIM; 3) the diagnosis of EIM itself implies a worse prognosis of the disease and 4) in addition, these EIM have a very significant impact on the productivity and quality of life of patients.

On the other hand, in the last 5-8 years there has been a striking increase in the number of possible treatments for IBD, including biologics and small molecules. However, there is a current challenge in terms of treatment positioning since we lack evidence to know what would be the most appropriate treatment for a particular patient in a specific clinical situation.
One of the most relevant aspects that we need to take into account when choosing a treatment is the disease phenotype and the presence of EIM, since we know that not all treatments will have a positive effect on the different EIM.

Therefore, and because IBD is a multifactorial disease in which the impact of the disease goes far beyond intesintal activity, it has also been proposed in recent years that IBD should be treated holistically as the most appropriate approach, ideally by a multidisciplinary team with expertise in this field.

The primary objective of this project is twofold:
1) to analyse the prevalence of pre-existing EIM at diagnosis, 2) as well as the incidence of new EIM during follow-up of IBD.
As secondary objectives
1) to evaluate the impact of different treatments on EIM.
2) to analyse the impact of these EIM on patients' quality of life and productivity. 

A prospective, single-centre, multidisciplinary study will be conducted for this purpose.
All newly diagnosed patients will be referred to a rheumatologist and dermatologist to rule out possible IEM.
In addition, patients will be seen at these consultations 6 and 12 months after diagnosis, or earlier in case of symptoms. 

IBD follow-up will follow our current ‘standard of care’ with clinical, biochemical, endoscopic and radiological parameters.
Questionnaires on quality of life and productivity will also be completed.

With this project, we thus aim not only to analyse the prevalence and impact of EIM on the evolution of disease and quality of life of our IBD patients, but also to better understand the clinical response and evolution of EIM to different treatments, in order to better target treatment choices in the future.

The expertise of the departments of dermatology and rheumatology at UZ Gent in inflammatory diseases, including IBD, is recognised nationally and internationally.At the same time, there is excellent clinical and research collaboration between the departments of gastroenterology, dermatology and rheumatology, both on a research and clinical level, with monthly IMID meeting, joint consultations and then 3 monthly research meeting (related to a GOA project we have together, with code 01G03122). This IMID group provides an ideal environment for projects like this.