Increasing evidence points to a mechanistic link between gut and joint pathology as the gut contains the largest number of immune cells of any tissue and trillions of commensals that contribute to immune development and homeostasis. New research is putting the role of Ruminococcus gnavus in arthritic disease in the spotlight.

The treatment of IBD is currently suboptimal. Continuous monitoring of patients with IBD, patient engagement and early treatment adjustments are still difficult hurdles. E-Health could be an efficient tool to improve these aspects, but the current evidence for its use in IBD is poor. An integrated cost-effective e-health system supported by a stable legal framework is eagerly needed.

Symptom-based diagnostic criteria have been criticized for being overly complex and performing modestly in differentiating organic from functional gastrointestinal diseases. The new Rome IV criteria now supersede Rome III. In general, these minor amendments are unlikely to lead to substantial improvement in accuracy and use in routine clinical care. Is a different approach required in future?