The immune system whispers a warning ten years before bowel disease arrives

Crohn's disease and ulcerative colitis — together, inflammatory bowel disease — usually announce themselves with symptoms. But the immune system starts changing its tune far earlier. In a study presented at UEG Week 2026, researchers analysed 2,000 blood samples from 500 people, taken at diagnosis and roughly two, four and ten years before it, profiling antibodies against some 357,000 targets. People who later developed Crohn's or colitis carried distinct antibody patterns up to a decade ahead, and machine-learning models could tell future patients from healthy controls with strong accuracy — even flagging, years early, who would develop complicated Crohn's. Lead author Arno Bourgonje stresses this is proof of principle, not a screening test yet: the signatures must be validated in larger, more diverse groups. Still, a decade of warning is a decade of possibility.

SDG 3 · Good health and well-being — Mechanism: tech innovation