{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T11:01:39Z","timestamp":1763636499274,"version":"3.45.0"},"reference-count":43,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Gastrointestinal (GI) sarcoidosis is a rare manifestation of systemic disease, with limited evidence to guide diagnosis and treatment. Methods: A 75-item international survey was completed by 132 clinicians from multiple specialties and hospital settings. Statistical analysis was performed using Jamovi version 2.6.44 (The Jamovi Project, Sydney, Australia). Results: Most clinicians (72.0%) preferred a comprehensive diagnostic approach integrating clinical, imaging and histopathological assessment, with differences by hospital type (p &lt; 0.05). Inflammatory bowel disease was frequently considered in the differential diagnosis, and concern regarding excluding inflammatory conditions remained consistently high. Significant specialty-related variation was observed for specific organ involvement and in the management of glucocorticoid-refractory disease, including use of alternative immunosuppressants, combination regimens, glucocorticoid-sparing agents, and biologic therapies. Expectations regarding response timelines and indications for surgery were largely concordant. Conclusions: Clinicians reported high awareness but heterogeneous management practices for GI sarcoidosis, particularly beyond first-line glucocorticoids. These findings highlight the need for multidisciplinary consensus and the development of standardized clinical guidelines.<\/jats:p>","DOI":"10.3390\/jcm14228231","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T10:30:59Z","timestamp":1763634659000},"page":"8231","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multinational Survey on the Symptom Approach to Diagnosis and Therapy Adopted by Physicians in the Treatment of Gastrointestinal Sarcoidosis"],"prefix":"10.3390","volume":"14","author":[{"given":"Salvatore","family":"Nicolosi","sequence":"first","affiliation":[{"name":"Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"Monteleone","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Pulmonary Sciences, Catholic University of Sacred Heart, 00168 Rome, Italy"},{"name":"Department of Pneumology, Ruhrlandklinik, University Hospital, University of Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2076-7319","authenticated-orcid":false,"given":"Giulia","family":"Bandini","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, Division of Internal Medicine, Azienda Ospedaliera Universitaria Careggi, University of Florence, 50134 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3361-4909","authenticated-orcid":false,"given":"Michael","family":"Hughes","sequence":"additional","affiliation":[{"name":"Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Science, School of Biological Sciences, The University of Manchester, Manchester M13 9PT, UK"},{"name":"Department of Rheumatology, Northern Care Alliance NHS Foundation Trust, The University of Manchester, Manchester M13 9PL, UK"},{"name":"NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester M6 8HD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zsuzsanna","family":"McMahan","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030-5401, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8351-3703","authenticated-orcid":false,"given":"Elena","family":"Bargagli","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"Martone","sequence":"additional","affiliation":[{"name":"Amici Contro la Sarcoidosi Italia ets, 40137 Bologna, Italy"},{"name":"Associazione Nazionale per l\u2019Assistenza e la Ricerca Integrata Contro la Sarcoidosi, 00152 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Ziosi","sequence":"additional","affiliation":[{"name":"Amici Contro la Sarcoidosi Italia ets, 40137 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7284-5016","authenticated-orcid":false,"given":"Paola","family":"Confalonieri","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4791-768X","authenticated-orcid":false,"given":"Marco","family":"Confalonieri","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8639-2882","authenticated-orcid":false,"given":"Paolo","family":"Cameli","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8990-859X","authenticated-orcid":false,"given":"Barbara","family":"Ruaro","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"w30049","DOI":"10.4414\/SMW.2022.w30049","article-title":"Sarcoidosis\u2014A multisystem disease","volume":"152","author":"Franzen","year":"2022","journal-title":"Swiss Med. 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