Colonoscopy in inflammatory bowel disease

Pera, A.; Bellando, P; Caldera, Daniela; Ponti, V.; Astegiano, Marco; Barletti, C.; David, Ezio; Arrigoni, Arrigo; Rocca, Giuseppe; Verme, G

doi:10.1016/0016-5085(87)90856-0

Cited by 213 publications

(19 citation statements)

References 20 publications

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“…Destacamos la baja sensibilidad discriminativa de la histología en nuestro medio, siendo la sintomatología y la técnica endoscópica más sensibles para la CU, como ya ha sido descrito por Pera y cols. (27), autor que señala un 90% de seguridad diagnóstica. Por el contrario, en la EC, es la Radiología la técnica de mayor seguridad diagnóstica, aunque este dato está sesgado debido a la alta frecuencia de enfermos que sólo tienen localización ileal de su enfermedad y por tanto radiológicamente demostrable.…”

Section: Discussionunclassified

Epidemiología de la enfermedad inflamatoria intestinal crónica en cinco áreas de Asturias: España

Gismera

Menéndez

Sánchez‐Fernández³

et al. 2003

An. Med. Interna (Madrid)

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RESUMENObjetivo: La epidemiología de la enfermedad inflamatoria intestinal crónica (EIIC) es una poderosa herramienta de investigación que contribuye a la evaluación de los factores medioambientales que influyen en su etiología. El objetivo de este estudio es conocer distintos aspectos epidemiológicos de la EIIC en nuestro medio.Pacientes y métodos: Estudio epidemiológico descriptivo, poblacional, multicentrico, retrospectivo entre 1954 y 1993 y prospectivo entre 1994 y 1997. Se incluyen 1018 enfermos mayores de 14 años, diagnosticados de EIIC en 5 áreas del Principado de Asturias (España), con un censo de 461.965 habitantes.Resultados: Del total de 1018 identificados [565 CU (55,5%) (incluyendo proctitis), 415 EC (40,8%) y 38 CI (3,7%)], 482 son mujeres (47,2%) y 536 varones (52,8%), con una relación V/M de 1,11. La edad media al diagnóstico es de 39,49 ± 1,08 (IC; 95%: 38,41 -40,57), [CU: 43,95 ± 1,47; EC: 33,53 ± 1,51; CI: 38,26 ± 5,14]. p = 0,000. La edad media de inicio de síntomas previo al diagnóstico es 37,66 ± 0,97 (CU: 42,84 ± 1,34; EC: 30,68 ± 1,40; CI: 36,74 ± 4,86 (p = 0,000). El diagnós-tico de CU ha sido posible con criterios clínicos en el 97,34% (p = ns), criterios endoscópicos en el 96,63% (p = 0,000) y criterios histológicos en el 90,26% (p = 0,000). En la EC: criterios radiológicos 83,61% (p = 0,000). El nivel cultural es superior en la EC: 57,57 (p = 0,0005). Asociación familiar del 8,4%. Extensión: en la CU: proctitis 13,6%, 26,9% colitis distal, 26% colitis izquierda, 6% colitis extensa y el 20% pancolitis; En la EC el 30,3% tienen afectación de íleon terminal, el 16,7% colon, el 41,3% colon e intestino, el 11,7% son intestinales extensas y el 3,7% tienen afectación gastro-duodenal; En la CI destaca un 39,5% de afectación discontinua. La media de cirugías necesarias para el control de la enfermedad es de 0,44 ± 6,11, (26,62% de los enfermos). CU: 0,12 ± 3,33 (9,91%); EC: 0,91 ± 12,9 (50,36%), p = 0,000. Tasa de Mortalidad de 47,15 /1000 habitantes (CU: T = 61,94; EC: T = 26,50; CI: T= 0,004) p = 0,046. RMS: 0,467 (CU: 6,14; EC: 2,63; CI: 100).Conclusiones: Este estudio que abarca una importante población de enfermos, pretende aportar nuestros resultados epidemiológicos a la Enfermedad Inflamatoria Intestinal Crónica. Nuestros resultados no difieren substancialmente de los de otras publicaciones. La colitis ulcerosa y la enfermedad de Crohn así como el sexo, se distribuyen uniformemente. La elevada asociación familiar entre estas enfermedades sugiere un origen genético de la EIIC. La enfermedad de Crohn se expresa con mayor morbilidad reflejada en los requerimientos quirúrgicos, pero sin embargo con menor mortalidad que en la colitis ulcerosa.PALABRAS CLAVE: Enfermedad Inflamatoria Intestinal Crónica. Colitis ulcerosa. Enfermedad de Crohn. Colitis indeterminada. Epidemiología. ABSTRACT Aims: The epidemiologic analysis inflammatory bowel disease (IBD) is a powerful research tool to assess the contribution of environmental factors to its etiology. IBD has been reported to have varying freque...

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Section: Discussionunclassified

Epidemiología de la enfermedad inflamatoria intestinal crónica en cinco áreas de Asturias: España

Gismera

Menéndez

Sánchez‐Fernández³

et al. 2003

An. Med. Interna (Madrid)

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“…Another distinctive feature that may support a diagnosis of Crohn's disease is the marked widening of the submucosal layer (may be displayed 100% in resected bowel specimens). The widened submucosa is due to edema, fibrosis, lymphangiectasis, telangiectasis and lymphoid aggregation 7,13 . In contrast to these changes, a narrowed or obliterated submucosal layer and the destruction of muscularis propria could be more commonly observed in intestinal tuberculosis 13,14 .…”

Section: Discussionmentioning

confidence: 99%

“…This low detectable rate in biopsy specimen was due to the limitations of biopsy sampling (too small and superficial). This may also be the reason why the importance of colonoscopic biopsy is often not realized by many clinicians 13 . However, the critical features suggestive of making an accurate diagnosis of Crohn's disease are shown in Table 2.…”

Section: Discussionmentioning

confidence: 99%

“…The widened submucosa is due to edema, fibrosis, lymphangiectasis, telangiectasis and lymphoid aggregation. 7,13 In contrast to these changes, a narrowed or obliterated submucosal layer and the destruction of muscularis propria could be more commonly observed in intestinal tuberculosis. 13,14 In the present study, a widened submucosal layer was observed in resected bowel specimens (84.6%) ( Table 2), however, only it was observed in only 15.4% in endoscopic biopsy specimens.…”

Section: Discussionmentioning

confidence: 99%

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Colonoscopic and histologic features of colonic Crohn's disease in Chinese patients

Zheng¹,

Cu²,

Shi³

et al. 2007

J of Digest Diseases

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“…Ileocolonoscopy, with visualisation of the terminal ileum and all colonic segments, should be performed (level A) [1,10,11]; at least two biopsies of every segment and the rectum (in areas that appear both normal and abnormal), should be taken to support diagnosis (level D) [12]. …”

Section: Assessment At Diagnosismentioning

confidence: 99%

Monitoring Disease Activity and Progression in Crohn's Disease. A Swiss Perspective on the IBD Ahead ‘Optimised Monitoring' Recommendations

Sauter

Beglinger²,

Girardin³

et al. 2014

Digestion

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Background and Aims: The structured IBD Ahead ‘Optimised Monitoring' programme was designed to obtain the opinion, insight and advice of gastroenterologists on optimising the monitoring of Crohn's disease activity in four settings: (1) assessment at diagnosis, (2) monitoring in symptomatic patients, (3) monitoring in asymptomatic patients, and (4) the postoperative follow-up. For each of these settings, four monitoring methods were discussed: (a) symptom assessment, (b) endoscopy, (c) laboratory markers, and (d) imaging. Based on literature search and expert opinion compiled during an international consensus meeting, recommendations were given to answer the question ‘which diagnostic method, when, and how often'. The International IBD Ahead Expert Panel advised to tailor this guidance to the healthcare system and the special prerequisites of each country. The IBD Ahead Swiss National Steering Committee proposes best-practice recommendations adapted for Switzerland. Methods: The IBD Ahead Steering Committee identified key questions and provided the Swiss Expert Panel with a structured literature research. The expert panel agreed on a set of statements. During an international expert meeting the consolidated outcome of the national meetings was merged into final statements agreed by the participating International and National Steering Committee members - the IBD Ahead ‘Optimized Monitoring' Consensus. Results: A systematic assessment of symptoms, endoscopy findings, and laboratory markers with special emphasis on faecal calprotectin is deemed necessary even in symptom-free patients. The choice of recommended imaging methods is adapted to the specific situation in Switzerland and highlights the importance of ultrasonography and magnetic resonance imaging besides endoscopy. Conclusion: The recommendations stress the importance of monitoring disease activity on a regular basis and by objective parameters, such as faecal calprotectin and endoscopy with detailed documentation of findings. Physicians should not rely on symptoms only and adapt the monitoring schedule and choice of options to individual situations.

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Colonoscopy in inflammatory bowel disease

Cited by 213 publications

References 20 publications

Epidemiología de la enfermedad inflamatoria intestinal crónica en cinco áreas de Asturias: España

Epidemiología de la enfermedad inflamatoria intestinal crónica en cinco áreas de Asturias: España

Colonoscopic and histologic features of colonic Crohn's disease in Chinese patients

Monitoring Disease Activity and Progression in Crohn's Disease. A Swiss Perspective on the IBD Ahead ‘Optimised Monitoring' Recommendations

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