Background/Objectives: Limited data exist on the epidemiology and clinical management of short bowel syndrome (SBS) and chronic intestinal failure (CIF) in Crohn’s disease (CD). This study aimed to evaluate these aspects in Italy. Methods: Members of the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) were invited to complete a cross-sectional web survey. A subgroup analysis examined the influence of different clinical settings on SBS and CIF management in CD. Results: A total of 47/128 (36.7%) IG-IBD centers participated. Among them, 31.9% were teduglutide (TED) prescribers, and 48.9% were academic centers. The median estimated prevalence of CIF among small bowel CD patients was 1%, and it was significantly higher in academic centers (2.0% [IQR 1–5%] vs. 0.13% [IQR 0–1%], p = 0.02). Seventy-eight percent of centers managed fewer than 10 SBS and CD patients. Routine small bowel measurement and nutritional assessment were performed in only 15% and 42.6% of centers, respectively. TED was prescribed by 12 centers to 35 patients, with a treatment success rate exceeding 50% in 81.8% of centers. Conclusions: The estimated prevalence of CIF in CD patients with small bowel involvement in Italy is 1%. The diagnosis and management practices for SBS and CIF are suboptimal, and TED use is limited.

Objectives: Linked-colour imaging/blue-laser imaging (LCI/BLI) and CAD-EYE artificial intelligence have been developed for sporadic colorectal neoplasia, but their role in ulcerative colitis (UC) surveillance remains uncertain. We evaluated CAD-EYE-assisted detection and optical characterization using conventional and disease-specific classifications in UC. Methods: In this prospective tandem study, patients with UC undergoing surveillance colonoscopy were examined sequentially using white-light imaging (WLI), LCI, and LCI with CAD-EYE. Lesions were characterized using BLI with Kudo, NICE, and Kudo-IBD classifications, followed by CAD-EYE characterization. Detection and characterization performance were assessed using miss rates and diagnostic accuracy. Results: Among 82 patients, 281 lesions, including 22 neoplastic lesions, were identified. The lesion miss rate decreased from 5.7% with WLI to 2.5% with LCI, while no lesions were missed during the CAD-EYE-assisted withdrawal. However, the fixed examination sequence and absence of prospectively recorded withdrawal times precluded isolation of CAD-EYE’s incremental contribution. The neoplasia miss rate was numerically lower with CAD-EYE than with WLI and LCI, although not significantly. Kudo-IBD showed the highest diagnostic performance, with sensitivity, specificity, and positive and negative predictive values of 90.9%, 85.3%, 34.5%, and 99.1%, respectively. Accuracy was significantly higher with KUDO-IBD than with all other methods (all p < 0.001). Conclusions: In this sequential protocol, CAD-EYE-assisted imaging was associated with complete observed lesion detection, whereas Kudo-IBD provided superior optical characterization. These findings support complementary AI-assisted detection and disease-specific optical assessment. Larger studies with independent examination sequences and prospectively recorded withdrawal times, together with external validation of Kudo-IBD, are needed.