{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:15:52Z","timestamp":1792080952469,"version":"4.4.0"},"reference-count":73,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Inflammatory bowel disease (IBD)\u2014including Crohn\u2019s disease, ulcerative colitis, and indeterminate colitis\u2014is a chronic immune-mediated condition that primarily affects the intestinal mucosa but often presents with extraintestinal digestive manifestations, which are important yet frequently underrecognized sources of morbidity. These heterogeneous manifestations reflect diverse genetic, microbial, immunologic, and environmental influences, highlighting the value of a personalized medicine approach. Hepatobiliary involvement affects IBD adults patients and is even more common in children, ranging from mild liver enzyme elevations to severe complications such as liver failure, with autoimmune disorders, cholelithiasis, portal vein thrombosis, and non-alcoholic fatty liver disease as key considerations. Pancreatic manifestations may include autoimmune or acute pancreatitis, often linked to gallstones, thiopurine exposure, or duodenal Crohn\u2019s disease, while splenic abnormalities, such as granulomatous lesions, splenomegaly, or functional hyposplenism, reflect systemic immune dysregulation. Oral findings\u2014including aphthous ulcers, periodontitis, pyostomatitis vegetans, and granulomatous cheilitis\u2014can serve as early, patient-specific indicators of disease activity. Personalized approaches, encompassing investigations tailored to the individual profile and selected targeted therapies, are essential for improving diagnostic accuracy, preventing complications, and optimizing multidisciplinary care in patients with IBD.<\/jats:p>","DOI":"10.3390\/jpm16040219","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T11:35:42Z","timestamp":1776339342000},"page":"219","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Beyond\u00a0the Gut: Extra-Enteric Digestive Manifestations of Inflammatory Bowel Disease\u2014A Personalized Medicine Perspective and Comprehensive Review"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5617-2432","authenticated-orcid":false,"given":"Maria","family":"Rogalidou","sequence":"first","affiliation":[{"name":"Division of Gastroenterology Hepatology & Nutrition, 1st Pediatrics Department, National and Kapodistrian University of Athens, \u201cAgia Sofia\u201d Children\u2019s Hospital, Thivon & Papadiamantopoulou Street, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9358-9480","authenticated-orcid":false,"given":"Maria-Veatriki","family":"Christodoulou","sequence":"additional","affiliation":[{"name":"Radiology Department, University Hospital of Ioannina, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandros","family":"Skamnelos","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, University Hospital of Ioannina, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9694-1160","authenticated-orcid":false,"given":"Dimitrios K.","family":"Christodoulou","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, University Hospital of Ioannina, 45500 Ioannina, Greece"},{"name":"Division of Gastroenterology, Medical School of Ioannina, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2265028","DOI":"10.1080\/19490976.2023.2265028","article-title":"Current insights on the roles of gut microbiota in inflammatory bowel disease-associated extra-intestinal manifestations: Pathophysiology and therapeutic targets","volume":"15","author":"Tie","year":"2023","journal-title":"Gut Microbes"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1093\/ecco-jcc\/jjae002","article-title":"Beyond the gut: A systematic review and meta-analysis of advanced therapies for inflammatory bowel disease-associated extraintestinal manifestations","volume":"18","author":"Budai","year":"2024","journal-title":"J. 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