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Introduction: The climate crisis has serious consequences for many areas of life. This applies in particular to human health - also in Europe. While cardiovascular, pneumological and dermatological diseases related to the climate crisis are often discussed, the crisis' significant gastroenterological consequences for health must also be considered., Methods: A literature search (Pubmed, Cochrane Library) was used to identify papers with relevance particularly to the field of gastroenterology in (Central) Europe. Findings were supplemented and discussed by an interdisciplinary team., Results: The climate crisis impacts the frequency and severity of gastrointestinal diseases in Europe due to more frequent and severe heat waves, flooding and air pollution. While patients with intestinal diseases are particularly vulnerable to acute weather events, the main long-term consequences of climate change are gastrointestinal cancer and liver disease. In addition to gastroenteritis, other infectious diseases such as vector-borne diseases and parasites are important in the context of global warming, heat waves and floods., Discussion: Adaptation strategies must be consistently developed and implemented for vulnerable groups. Patients at risk should be informed about measures that can be implemented individually, such as avoiding heat, ensuring appropriate hydration and following hygiene instructions. Recommendations for physical activity and a healthy and sustainable diet are essential for the prevention of liver diseases and carcinomas. Measures for prevention and the promotion of resilience can be supported by the physicians at various levels. In addition to efforts fostering sustainability in the immediate working environment, a system-oriented commitment to climate protection is important., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Introduction: Fatigue is a common symptom in patients with inflammatory bowel diseases (IBD). To date, there is no instrument to assess IBD-specific fatigue in German. The aim of this study was to translate the IBD Fatigue (IBD-F) scale and to test its psychometric properties in a German IBD population., Methods: After completing the translation process, 20 IBD patients participated in a pilot testing phase. For further analyses, 180 IBD patients with fatigue answered the IBD-F (Sections I, II, III) and the IBD Questionnaire (IBDQ-D). Reliability was tested by using Cronbach's alpha and corrected item-total correlation. Exploratory factor analyses (EFA) were carried out. Spearman's correlation was calculated between the IBD-F and IBDQ-D . 78 patients could be included to calculate the test-retest reliability., Results: The German version of the IBD-F shows high face and content validity. Internal consistency was excellent, with a Cronbach's alpha of 0.93-0.98. Corrected item-total correlations ranged from 0.51 to 0.89. The correlation between the IBD-F and the IBDQ-D was statistically significant for Section I (rs=-0.59; p<0.01) and Section II (rs=-0.76; p<0.01) of the IBD-F. The EFA identified one relevant factor for each section. Test-retest reliability was acceptable for Section I (intraclass correlation coefficient (ICC)=0.73) and Section II (ICC=0.84)., Conclusion: The German version of the IBD-F is a reliable and valid tool to assess fatigue in IBD., Competing Interests: U.v.A. received consulting and/or speaker fees from ESOCAP, Abbvie, MSD, Takeda, Falk Pharma; R.R. received speaker fee from Abbvie; A.K.T. received speaker and consulting fees from Janssen Cilag, speaker fees from Pfizer and MSD and travel support from Abbvie and Takeda; J.W. received consulting and/or speaker fees from Abbvie Deutschland, Takeda Pharma, Janssen-Cilag GmbH; N.T. received personal fees from AbbVie, MSD, Falk, Janssen, Takeda and Vifor outside the submitted work., (Thieme. All rights reserved.)

Background: Vaccination against SARS-CoV-2 is a promising strategy to protect immunocompromised IBD patients from a severe course of COVID-19. As these patients were excluded from initial clinical vaccination trials, patients frequently express concerns regarding the safety of these vaccines, especially whether vaccination might trigger IBD flares ("hit-and-run-hypothesis")., Methods: In order to assess the risk of an IBD flare after vaccination against SARS-CoV-2, an anonymous survey was performed at five German IBD centers and one patient organization (Deutsche Morbus Crohn/Colitis ulcerosa Vereinigung (DCCV) e.V.) in August and October 2021., Results: The questionnaire was answered by 914 patients, 781 of whom reported a previous vaccination against SARS-CoV-2 (85.4%). Vaccination against SARS-CoV-2 was not associated with an increased risk of IBD flares (p=0.319) or unscheduled visits to the IBD physician (p=0.848). Furthermore, typical symptoms of an IBD flare including abdominal pain, increases in stool frequency, or rectal bleeding were not influenced by the vaccination., Conclusion: Vaccination against SARS-CoV-2 is safe in IBD patients. These results may help to reduce fears regarding the vaccination in IBD patients. Our results can help to reduce fears in IBD patients regarding the SARS-CoV-2 vaccine. A close communication between patients and physicians before and after the vaccination may be beneficial., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Introduction: The influence of a SARS-CoV-2 infection on inflammatory bowel disease (IBD) has not yet been well characterized and it is unclear whether this requires an adaptation of the immunosuppressive therapy., Methods: A national register was established for the retrospective documentation of clinical parameters and changes in immunosuppressive therapy in SARS-CoV-2 infected IBD patients., Results: In total, only 3 of 185 IBD patients (1.6 %) were tested for SARS-CoV-2 infection because of abdominal symptoms. In the course of COVID-19 disease, 43.5 % developed diarrhea, abdominal pain or hematochezia (risk of hospitalization with vs. without abdominal symptoms: 20.0 % vs. 10.6 %, p < 0.01). With active IBD at the time of SARS-CoV-2 detection, there was an increased risk of hospitalization (remission 11.2 %, active IBD 23.3 % p < 0.05). IBD-specific therapy remained unchanged in 115 patients (71.4 %); the most common change was an interruption of systemic therapy (16.2 %)., Discussion: New abdominal symptoms often appeared in SARS-CoV-2 infected IBD patients. However, these only rarely led to SARS-CoV-2 testing. A high IBD activity at the time of SARS-CoV-2 detection was associated with an increased risk of hospitalization., Competing Interests: NT erhielt Vortrags- und Beratungshonorare von Abbvie, Celltrion, Janssen, Falk Foundation, MSD, Takeda und Vifor.RS erhielt Vortrags- und Beratungshonorare von Abbvie, BMS/Celgene, Janssen, Pharmacosmos, MSD, Takeda, Falk Foundation. JW erhielt Referenten- und/oder Beratungshonorar von Abbvie, Janssen, Pfizer Pharma und Takeda.TK erhiehlt Vortrags- und Beratungshonorare von AbbVie, MSD, Pfizer, Ferring, Takeda, JanssenCM erhielt Vortrags- und Beratungshonorare von Abbvie, Biogen, Dr. Falk PharmaGmbH, Galapagos, Gilead, Janssen, MSD Sharp & Dome GmbH, Pfizer, Roche, Samsung, TakedaPharmaGmbH, Vifor PharmaWM erhielt Vortrags- und Beratungshonorare von Abbvie, alanta health service, Almirall, Amgen, Aptalis, biogen, Falk, Gilead, Hexal, Janssen, MSD, Pfizer, Synformulas, Takeda Tillotts, Vifor.HHW erhielt Vortrags- und Beratungshonorare von Abbott, Abbvie, Altimmun, Bayer, Biotest, BMS, BTG, Dicerna, Eisai, Falk, Gilead, Gore, Intercept, Janssen, Merck, MSD, Merz, MYR GmbH, Norgine, Roche und Siemens.CB erhielt Vortrags- und Beratungshonorare von Abbott, Amgen, Biogen, Falk Foundation, Galapagos, GlaxoSmithKline, Janssen, MSD, Pfizer, Shield, Takeda, ViforPCG erhielt Vortrags- und Beratungshonorare von Abbvie, Janssen, Pfizer, TakedaPH erhielt Vortrags- und Beratungshonorare von Falk foundation, Abbvie, MSD, Pfizer, Janssen und Takeda MH erhielt Beratungshonorare von TakedaStS erhielt Vortrags- und Beratungshonorare von Abbvie, Amgen, Biogen, Falk, Janssen, MSD, Pfizer, Takeda, TillottsUvA erhielt Vortrags- und Beratungshonorare von Abbvie, MSD, Takeda, Esocap, Janssen, Falk Foundation, Recordati Pharma, Vifor Pharma.AS erhielt Vortrags- und Beratungshonorare von Abbvie, Amgen, Astellas, Biogen, Celltrion, Consal, CSL Behring, Falk Foundation, Ferring, Galapagos, Gilead, Institut Allergosan, Janssen, MSD, Norgine, Pfizer Pharma, Recordati Pharma, Roche, Shire, Summit Therapeutics und Takeda.ECB, TB, OE, BH, CL, SN, MK, KSt und KSch berichten keine Interessenkonflikte, (Thieme. All rights reserved.)

Background:  In patients with inflammatory bowel disease (IBD), diagnosis is often established at the beginning of childbearing age. Accordingly, concerns about family planning and pregnancy (FPP) are common. Poor knowledge regarding FPP might contribute to increased childlessness in patients with IBD., Methods:  The Crohn's and Colitis Pregnancy Knowledge Score (CCPKnow, 17 multiple-choice questions) was translated into German and then used for a web-based survey. Childlessness was analyzed with respect to socio-demographic and disease-related information, and the knowledge (CCPKnow) and concerns of IBD patients with children were compared to those of voluntarily childless (VC) and non-voluntarily childless (NVC) IBD patients., Results:  Childlessness was observed in 57.4 % of the 533 participants (90.6 % women, 63.0 % Crohn's disease, 31.5 % ulcerative colitis, mean age 33.2 ± 8.6 years), voluntary childlessness in 9 %. The mean overall CCPKnow was adequate (9.38 ± 3.96). Poor knowledge was not associated with increased childlessness (CCPKnow of < 8 was found in 29.8 % of patients with children and 28.9 % of childless patients, p > 0.5). Instead, the patients' education, medical advice, FPP-related concerns, impaired body image, and sexual dysfunction had a significant impact on childlessness. Frequent concerns included adverse effects of the patient's medication on their child (36 % of the respondents), malformation (33 %), miscarriage (34.5 %), and the inheritability of IBD (57 %)., Conclusions:  Factual knowledge does not reduce disease-related concerns or childlessness. Correct but possibly bothersome information on FPP might contribute to childlessness in patients with IBD. Our findings underline the need for qualified counseling of IBD patients regarding FPP by an experienced IBD physician., Competing Interests: JW has served as a speaker, consultant and/or an advisory board member for AbbVie, Janssen, MSD, Takeda. EP, RG, AR, and PM declare no conflicts of interest.The authors received no specific funding for this work., (Thieme. All rights reserved.)

We report on a 30-year-old patient who presented with bloody diarrhoea. After initially, assuming a previously not diagnosed ulcerative colitis, an immunosuppressive therapy was initiated, a week later an HIV infection stage C2 according to the CDC classification, complicated by CMV viraemia, was diagnosed. In this case report the course of treatment with highly active antiretroviral therapy (HAART), ganciclovir and prednisolone is reported and discussed on the basis of histological, immunohistochemical and microbiological findings. The case illustrates the difficulty to distinguish between ulcerative colitis, immune reconstitution syndrome, CMV colitis and HIV-associated diarrhoea., (© Georg Thieme Verlag KG Stuttgart · New York.)