Therapeutic innovation in gastroenterology has accelerated over the past decade, reshaping how clinicians evaluate treatment response, define success, and identify unmet needs across inflammatory and metabolic diseases. As the armamentarium expands, so too does the complexity of decision-making in both inflammatory bowel disease (IBD) and broader digestive disorders. The question is no longer whether options exist, but how to deploy them effectively—and when to pivot.
In the accompanying video, Benjamin McDonald, MD, PhD, a gastroenterologist specializing in inflammatory bowel diseases at UChicago Medicine, explains that early identification of suboptimal response remains grounded in careful clinical reassessment. In the absence of predictive biomarkers that reliably match individual patients to specific agents, clinicians must synthesize disease severity, distribution, comorbidities, and patient preferences. Clinical trial data provide practical benchmarks—particularly regarding expected timelines for response. Some therapies demonstrate benefit within weeks, whereas others may require months, informing when optimization or switching should be considered.