Gaps Between European Crohn's Colitis Organisation Quality Standards of Care and the Real World in Special Situations in Inflammatory Bowel Disease Across Europe: Results From E‐QUALITY Survey

Background Managing special situations in Inflammatory Bowel Disease (IBD)—such as surgery, nutrition, acute severe ulcerative colitis (ASUC) and paediatric‐to‐adult transition—is critical for patient outcomes. The European Crohn's and Colitis Organisation's (ECCO) E‐QUALITY initiative aimed to identify gaps between its evidence‐based care standards and real‐world clinical practice in these key areas. Methods The E‐QUALITY Taskforce conducted a web‐based survey across ECCO members. Data on institutional protocols and processes for surgery, nutrition, ASUC, paediatric‐to‐adult transition management were collected from 245 institutions across 35 European countries. Results The survey revealed significant heterogeneity in practice. Laparoscopic surgery for major IBD‐related bowel surgery was the preferred approach in 72% of institutions. Post‐operative recurrence prevention was reported in 57% of institutions. Pre‐operative nutritional screening for all surgical patients was standard in only 40% of institutions. For ASUC, a time‐bound, multidisciplinary management algorithm was in place in 30% of institutions. Only 35% of centres had a formal pathway for paediatric‐to‐adult transition. Guideline adherence was generally higher in larger, academic hospitals. Conclusion Substantial gaps exist between ECCO recommendations and real‐world clinical practice for managing these special IBD situations. These findings highlight an urgent need for targeted advocacy and educational initiatives for healthcare professionals, providers and patients to standardise care and improve outcomes in IBD management across Europe.