Episode Description: In this episode of Lion’s Digest – Advances in GI and Hepatology, host Dr. Manny Williams sits down with Dr. Matthew Coates to explore the emerging concept of “silent IBD.” While inflammatory bowel disease is often associated with significant gastrointestinal symptoms, some patients harbor active intestinal inflammation despite minimal or absent clinical symptoms—a phenotype that can delay diagnosis and treatment.

Dr. Coates discusses how clinicians can begin to recognize and identify patients with silent IBD, highlighting key clues from biomarkers, endoscopy, and cross-sectional imaging that may reveal ongoing disease activity even when patients report feeling well. The conversation also dives into his current research efforts aimed at better characterizing this underrecognized population and understanding why some individuals develop inflammation without the expected symptom burden.

A major focus of the discussion is the discovery of a gene associated with this silent IBD phenotype, offering new insights into the biological mechanisms that may influence symptom perception, immune signaling, and disease presentation. Dr. Coates explains how these findings could shape future diagnostics, risk stratification, and personalized treatment strategies for patients with IBD.

This episode provides a fascinating look at how genetics, immunology, and clinical observation are reshaping our understanding of inflammatory bowel disease—and why recognizing silent inflammation may be critical to preventing long-term complications.

Tune in to hear how Penn State researchers are advancing the science of IBD and what these discoveries could mean for the future of patient care.

Topics discussed include:

• What defines the silent IBD phenotype
• Strategies to detect inflammation in minimally symptomatic patients
• The role of biomarkers, endoscopy, and imaging
• New genetic discoveries linked to silent disease
• Implications for future research and personalized IBD care

We host Dr. Hadie Razjouyan from Penn State and Dr. Ibrahim Yaghnam from the University of Arizona for a discussion of their recent publication, "Impact of Scheduled Outpatient Endoscopy Procedures on Inpatient Endoscopy Procedures: Prospective Analysis from a Single Tertiary Care Center," published in Digestive Diseases and Sciences in August 2025. They discuss the rationale for the study, how it was executed, their results, and how these findings my impact and improve our inpatient Endoscopy scheduling processes.