Abstract
Classic inflammatory bowel diseases (IBD), in narrow sense, consisting of Crohn's disease (CD) and ulcerative colitis (UC), are chronic diseases with relapsing and remitting clinical courses. The phenotype of IBD is far from uniform. There are various immune-mediated disorders that are apparent simultaneously with IBD yet are not yet considered a part of the IBD encompassment. We propose an adjustment from the traditional concept of classic IBD to a broad spectrum of immune-mediated intestinal diseases and overlap syndromes. IBD may be further dichotomized into classic IBD or IBD variants and primary or secondary IBD. Secondary IBD may be triggered by changes of the body's “immune thermostat” by factors such as medications, organ transplantation, and surgery. Variables such as the genome, exposome, microbiome, and immunome shape the different diseases involved in the spectrum.
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