ASGE guideline: endoscopy in the diagnosis and treatment of inflammatory bowel disease

Leighton, Jonathan A.; Shen, Bo; Baron, Todd H.; Adler, Douglas G.; Davila, Raquel E.; Egan, James; Faigel, Douglas O.; Gan, S. Ian; Hirota, William K.; Lichtenstein, David R.; Qureshi, Waqar; Rajan, Elizabeth; Zuckerman, Marc J.; VanGuilder, Trina; Fanelli, Robert D.

doi:10.1016/j.gie.2006.02.005

Cited by 220 publications

(115 citation statements)

References 111 publications

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“…In Crohn's colitis, those patients with extensive disease involving more than one-third of the colon also have an increased risk of CRC, similarly to patients with UC. 37 The extent of colonic involvement should be based on both endoscopic and histologic criteria, which can reveal more-extensive disease. Patients with UC or extensive Crohn's colitis should undergo surveillance colonoscopy every one to two years, beginning eight to 10 years after disease onset.…”

Section: Inflammatory Bowel Diseases (Ibd)mentioning

confidence: 99%

Use of probe‐based confocal laser endomicroscopy (pCLE) in gastrointestinal applications. A consensus report based on clinical evidence

et al. 2015

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Background: Probe-based confocal laser endomicroscopy (pCLE) provides microscopic imaging during an endoscopic procedure. Its introduction as a standard modality in gastroenterology has brought significant progress in management strategies, affecting many aspects of clinical care and requiring standardisation of practice and training. Objective: This study aimed to provide guidance on the standardisation of its practice and training in Barrett's oesophagus, biliary strictures, colorectal lesions and inflammatory bowel diseases. Methods: Initial statements were developed by five group leaders, based on the available clinical evidence. These statements were then voted and edited by the 26 participants, using a modified Delphi approach. After two rounds of votes, statements were validated if the threshold of agreement was higher than 75%. Results: Twenty-six experts participated and, among a total of 77 statements, 61 were adopted (79%) and 16 were rejected (21%). The adoption of each statement was justified by the grade of evidence. Conclusion: pCLE should be used to enhance the diagnostic arsenal in the evaluation of these indications, by providing microscopic information which improves the diagnostic performance of the physician. In order actually to implement this technology in the clinical routine, and to ensure good practice, standardised initial and continuing institutional training programmes should be established.

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Section: Inflammatory Bowel Diseases (Ibd)mentioning

confidence: 99%

Use of probe‐based confocal laser endomicroscopy (pCLE) in gastrointestinal applications. A consensus report based on clinical evidence

et al. 2015

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“…3 Fulminant colitis is a contraindication for colonoscopy; however, flexible sigmoidoscopy may be considered. 4 If an upper gastrointestinal (GI) tract endoscopy is performed for suspected IBD, at least 2 biopsies from the esophagus, stomach, and duodenum are performed. 3 …”

Section: Endoscopy and Tissue Samplingmentioning

confidence: 99%

Clinical Aspects of Idiopathic Inflammatory Bowel Disease: A Review for Pathologists

Lee¹,

Westerhoff²,

Shen³

et al. 2016

Archives of Pathology &Amp; Laboratory Medicine

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Context.—Idiopathic inflammatory bowel disease manifests with different clinical phenotypes showing varying behavior and risk for neoplasia. The clinical questions that are posed to pathologists differ depending on phase of the disease and the clinical circumstances. Understanding the clinical aspects of the dynamic disease process will enhance the role of pathology in optimizing the care of patients with inflammatory bowel disease. Objective.—To review clinical and surgical aspects of inflammatory bowel disease that are relevant to practicing pathologists. Data Sources.—The literature was reviewed. Conclusions.—Diagnosis and management of inflammatory bowel disease require an integrated evaluation of clinical, endoscopic, radiologic, and pathologic features. Therefore, close interaction between clinicians and pathologists is crucial. Having this team approach improves understanding of the pertinent clinical and surgical aspects of the disease and assists in the recognition of unusual presentation of variants, as well as mimics of idiopathic inflammatory bowel disease, by pathologists.

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“…Complete and good quality mucosal visualization by colonoscopy with intubation of the ileum along with segmental mucosal biopsies is the most valuable tool to distinguish different types of inflammatory bowel disease (IBD), to differentiate IBD from other intestinal disorders, and to determining prognosis and the appropriateness of therapies, along with diagnosis and treatment of complications [81][82][83][84][85][86][87] . There have not been adequate studies to determine the best ways to prepare IBD patients for colonoscopy and to identify safety issues associated with different approaches.…”

Section: Inflammatory Bowel Diseasementioning

confidence: 99%

Achieving the best bowel preparation for colonoscopy

Parra‐Blanco¹,

Ruiz²,

Álvarez-Lobos³

et al. 2014

WJG

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Bowel preparation is a core issue in colonoscopy, as it is closely related to the quality of the procedure. Patients often find that bowel preparation is the most unpleasant part of the examination. It is widely accepted that the quality of cleansing must be excellent to facilitate detecting neoplastic lesions. In spite of its importance and potential implications, until recently, bowel preparation has not been the subject of much study. The most commonly used agents are high-volume polyethylene glycol (PEG) electrolyte solution and sodium phosphate. There has been some confusion, even in published meta-analyses, regarding which of the two agents provides better cleansing. It is clear now that both PEG and sodium phosphate are effective when administered with proper timing. Consequently, the timing of administration is recognized as one of the central factors to the quality of cleansing. The bowel preparation agent should be administered, at least in part, a few hours in advance of the colonoscopy. Several low volume agents are available, and either new or modified schedules with PEG that usually improve tolerance. Certain adjuvants can also be used to reduce the volume of PEG, or to improve the efficacy of other agents. Other factors apart from the choice of agent can improve the quality of bowel cleansing. For instance, the effect of diet before colonoscopy has not been completely clarified, but an exclusively liquid diet is probably not required, and a low-fiber diet may be preferable because it improves patient satisfaction and the quality of the procedure. Some patients, such as diabetics and persons with heart or kidney disease, require modified procedures and certain precautions. Bowel preparation for pediatric patients is also reviewed here. In such cases, PEG remains the most commonly used agent. As detecting neoplasia is not the main objective with these patients, less intensive preparation may suffice. Special considerations must be made for patients with inflammatory bowel disease, including safety and diagnostic issues, so that the most adequate agent is chosen. Identifying neoplasia is one of the main objectives of colonoscopy with these patients, and the target lesions are often almost invisible with white light endoscopy. Therefore excellent quality preparation is required to find these lesions and to apply advanced methods such as chromoendoscopy. Bowel preparation for patients with lower gastrointestinal bleeding represents a challenge, and the strategies available are also reviewed here. Core tip: Bowel preparation for colonoscopy is a central issue related to the quality of the procedure. There are different agents for bowel preparation that can be administered with different schedules. We review the most commonly used agents, as well as new agents and combinations. Moreover, certain considerations should be taken into account for special populations in order to improve safety, efficacy and tolerance. Regimens for bowel preparation in special situations are discussed, such as for pedi...

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ASGE guideline: endoscopy in the diagnosis and treatment of inflammatory bowel disease

Cited by 220 publications

References 111 publications

Use of probe‐based confocal laser endomicroscopy (pCLE) in gastrointestinal applications. A consensus report based on clinical evidence

Use of probe‐based confocal laser endomicroscopy (pCLE) in gastrointestinal applications. A consensus report based on clinical evidence

Clinical Aspects of Idiopathic Inflammatory Bowel Disease: A Review for Pathologists

Achieving the best bowel preparation for colonoscopy

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