Abstract Inflammatory bowel disease (IBD) is characterized by gut microbial dysbiosis, dysregulated host immune responses and increased susceptibility to certain intestinal infections. These factors complicate the distinction between active infection, inflammatory flare, and mixed inflammatory infectious states. Conventional diagnostics remain essential in clinical practice, but a single test is often insufficient to separate colonization, true infection, and inflammation‐related symptoms. This review summarizes current evidence on multi‐omics biomarkers relevant to intestinal infection and inflammation in IBD, including metagenomics, metabolomics, proteomics, single‐cell RNA sequencing, spatial transcriptomics and radiomics features. Biomarkers linked more closely to infection are considered alongside those that mainly reflect inflammatory activity, with attention to areas of overlap. The review also examines the degree of validation across studies, major sources of heterogeneity and confounding, and the strengths and limitations of emerging diagnostic platforms and artificial intelligence (AI) assisted integrative approaches. Overall, multi‐omics strategies may improve diagnostic stratification and deepen understanding of disease mechanisms in IBD. However, most candidate biomarkers and related platforms remain insufficiently validated for routine clinical use.
Yang et al. (Sun,) studied this question.