Introduction to the IBD Journal Supplement: “Prevention of IBD: Forecasting and Forestalling Inflammatory Bowel Disease Onset”

Despite significant therapeutic advances in inflammatory bowel disease (IBD), patients still experience diagnostic delays, suboptimal outcomes, and low remission rates—highlighting the urgent need for new approaches. This IBD journal supplement gathers leading experts to examine critical aspects of disease prediction and prevention. Topics include the genetic architecture of IBD, early-life environmental risk factors and their influence on disease risk, and emerging predictive biomarkers such as microbiome signatures, gut permeability, and proteomics, among others. Insights from type 1 diabetes research inform potential strategies for disease interception in IBD. Several targets are proposed for interception and prevention of disease, and the optimal design of an IBD-prevention trial is discussed. While landmark initiatives across the globe are currently paving the way for biomarker validation and trial implementation, harmonizing terminology and defining preclinical stages are essential next steps. Ultimately, understanding disease initiation may enable transformative strategies, shifting the paradigm from treatment to true prevention and potentially altering the course of IBD.