Raising Awareness and Understanding of Cytomegalovirus Colitis in Patients with Inflammatory Bowel Disease

Cytomegalovirus (CMV), a member of the Herpesviridae family, is a widespread virus that infects about half of all adults in the United States. Most infected individuals remain asymptomatic or experience mild symptoms, as the virus typically stays latent within the body. However, in immunocompromised individuals—such as those with inflammatory bowel disease (IBD)—CMV reactivation can occur more frequently, leading to serious complications. This reactivation particularly affects the colon, resulting in a condition known as CMV colitis.

CMV colitis is often underdiagnosed or misdiagnosed because its symptoms, including abdominal pain and fever, closely resemble an IBD flare. The overlapping clinical presentation complicates timely diagnosis and treatment, highlighting the importance of awareness among healthcare providers. According to Yale School of Medicine’s Alfredo Puing, MD, improving recognition of this condition can lead to better management strategies.

Treating CMV colitis involves a delicate balance between reducing immunosuppression to allow the immune system to combat the virus and maintaining adequate control of the underlying IBD. Commonly, corticosteroids and other immunosuppressive agents are withdrawn to help control the viral infection. Recent research emphasizes that newer biologic therapies might allow the continuation of IBD treatments during antiviral therapy, depending on their mechanisms of action.

In a recent review published in the journal "Viruses," Dr. Puing aimed to synthesize the latest findings on CMV colitis in adult IBD patients. The review underscores the necessity for tailored guidelines, as most existing protocols focus on transplant or hematological malignancy patients, not on those with IBD. Recognizing CMV as a potential cause of refractory IBD flares is critical for accurate diagnosis and effective management.

The primary goals of this research are to raise awareness and develop clear guidelines for healthcare professionals managing immunosuppressed IBD patients. Clarifying how long to treat CMV and which immunosuppressive medications to avoid, continue, or restart during antiviral treatment can significantly improve patient outcomes. With increased research and understanding, clinicians can better navigate the complexities of treating CMV colitis alongside ongoing IBD management.

Overall, improving awareness and evidence-based approaches can enhance the care and prognosis of patients facing this challenging condition.

Source: https://medicalxpress.com/news/2025-08-qa-awareness-cytomegalovirus-colitis.html