Impact of intestinal ultrasound on the management of patients with inflammatory bowel disease: how to apply scientific evidence to clinical practice

Fraquelli, Mirella; Castiglione, Fabiana; Calabrese, Emma; Maconi, Giovanni

doi:10.1016/j.dld.2019.10.004

Cited by 27 publications

(36 citation statements)

References 82 publications

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“…In fact, the use of non-invasive alternatives to endoscopy, at least for the monitoring of the effectiveness of therapy and to adhere to the “tight control” of disease activity, was a topic discussed even before COVID-19. 36 , 37 In detail, the symptoms to be evaluated in the PROs are the number of bowel movements and abdominal pain for CD and the number of bowel movements and rectal bleeding for UC. 38 Therefore, asymptomatic patients or patients with mild symptoms and normal values of biomarkers (CRP and calprotectin) need no outpatient visit, if restrictions on normal activities still persist.…”

Section: The Decaloguementioning

confidence: 99%

Covid-19 and the management of patients with inflammatory bowel disease: a practical decalogue for the post-pandemic phase

Papa

Lopetuso

et al. 2020

Therap Adv Gastroenterol

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The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has raised several concerns for patients with chronic immune-mediated diseases, including inflammatory bowel disease (IBD). As the outbreak appears to be in the descending phase, at least in some part of the world, as in most European countries, guidance is urgently needed to provide optimal care for our IBD patients in order to gradually and safely reduce the gap in care that has been accumulated in the months of lockdown and to face all the backlogs. Therefore, we have provided a decalogue of practical recommendations for gastroenterologists to manage patients with IBD in the post-peak phase of the COVID-19 pandemic. They include all the aspects of IBD care, not only pharmacological ones but also endoscopy, surgery, psychological treatment, telemedicine, diagnostics and educational tasks provided by doctors and patient associations.

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Section: The Decaloguementioning

confidence: 99%

Covid-19 and the management of patients with inflammatory bowel disease: a practical decalogue for the post-pandemic phase

Papa

Lopetuso

et al. 2020

Therap Adv Gastroenterol

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“…The diagnosis and the monitoring of CD is based on the combination of clinical, laboratory, and endoscopic findings; histopathological reports; and imaging studies. There are known advantages in terms of detection of BUS over endoscopy in several cases, such as an incomplete colonoscopy, proximal locations of disease (i.e., distant from the ileo-cecal valve), and complications (i.e., fistulas, abscesses, and strictures) [ 9 , 10 , 11 , 12 ]. The indications to perform BUS in CD patients are summarized in Table 2 .…”

Section: Crohn’s Disease In Bowel Ultrasoundmentioning

confidence: 99%

“…Current recommendations recognize BUS as a valid method for the assessment of the small bowel in newly diagnosed CD and, generally, for the monitoring of IBD [ 8 ]; however, a standardization of the intestinal and extraintestinal features of active disease is still needed. The main advantages of BUS are its non-invasiveness and low costs compared to computed tomography (CT) or magnetic resonance imaging (MRI) [ 9 ]. It has been recently demonstrated that when performed by a skilled operator, BUS has a comparable sensitivity and specificity to second-level techniques for assessing disease activity and complications of IBD [ 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…The main advantages of BUS are its non-invasiveness and low costs compared to computed tomography (CT) or magnetic resonance imaging (MRI) [ 9 ]. It has been recently demonstrated that when performed by a skilled operator, BUS has a comparable sensitivity and specificity to second-level techniques for assessing disease activity and complications of IBD [ 9 , 10 , 11 ]. Moreover, BUS is readily available and can be performed bedside by the dedicated gastroenterologist upon need (i.e., point-of-care BUS (POCBUS)) [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, BUS is readily available and can be performed bedside by the dedicated gastroenterologist upon need (i.e., point-of-care BUS (POCBUS)) [ 12 ]. The monitoring through BUS of the bowel wall thickness (BWT) predicts the outcomes of IBD patients, particularly in CD for its transmural features [ 9 , 10 , 11 ]. In this review, we aim to examine and summarize the technical aspects and the current evidence on BUS in the management of IBD, focusing on the detection of disease activity, complications, and the newly emerging transperineal approach.…”

Section: Introductionmentioning

confidence: 99%

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Bowel Ultrasound in Inflammatory Bowel Disease: How Far in the Grayscale?

Furfaro

Buono

Allocca

et al. 2021

Life

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Bowel ultrasound (BUS) is a non-invasive and accurate technique for assessing activity, extension of disease, and complications in inflammatory bowel diseases. The main advantages of BUS are its safety, reproducibility, and low costs. Ancillary technologies of BUS (i.e., color Doppler and wave elastography) could broaden the diagnostic power of BUS, allowing one to distinguish between inflammation and fibrosis. Considering the costs and invasiveness of colonoscopy and magnetic resonance, BUS appears as a fast, safe, and accurate technique. The objective measures of disease allow one to make clinical decisions, such as optimization, switch, or swap of therapy. Previous studies reported a sensitivity and a specificity of more than 90% compared to endoscopy and magnetic resonance. Lastly, transperineal ultrasound (TPUS) is a promising approach for the evaluation of perianal disease in Crohn’s disease (CD) and disease activity in patients with ulcerative proctitis or pouchitis. Bowel ultrasound is being incorporated in the algorithm of managing inflammatory bowel diseases. Transmural healing evaluated through ultrasonography is emerging as a complementary target for disease treatment. In this review, we aimed to summarize and discuss the current evidence on BUS in the management of inflammatory bowel diseases and to address the challenges of a full validation of this technique.

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Usefulness of Intestinal Ultrasound to Detect Small Intestinal Stenosis in Patients With Crohn's Disease

Takeuchi

Inokuchi

Takahara

et al. 2022

J of Ultrasound Medicine

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Objectives-Double balloon enteroscopy (DBE) with retrograde contrast is useful as a monitoring tool for small intestinal lesions in Crohn's disease (CD), but these are burdensome for patients. Intestinal ultrasound (IUS) can be used with ease in daily clinical practice, but there is less evidence regarding the accuracy of detection of small intestinal stenosis in CD. This study aimed to examine the diagnostic power of IUS for small intestinal stenosis in patients with CD.Methods-The findings of DBE and IUS in 86 patients with CD with small intestinal lesions were evaluated. Using DBE as the reference standard, we examined the detection rate of IUS for small intestinal stenosis. We evaluated three parameters: luminal narrowing, prestenotic dilation, and to-and-fro movement for determining stenosis using IUS. In addition, we compared the characteristics between the stenosis-detectable and stenosis-undetectable groups by IUS.Results-Of the 86 patients, 30 had small intestinal stenosis. In IUS findings, when lesions that met two or more of the three parameters were judged as stenosis, the detection rate was 70.0% for sensitivity, 98.2% for specificity, and 88.4% for accuracy. Moreover, there were patients with a younger age at diagnosis (P < 0.05) and more ileocolonic disease location (P < 0.05) in the stenosisdetectable group by IUS. The stenoses detected by IUS were significantly longer than those undetected by IUS (14.1 mm versus 5.2 mm, P < 0.05).Conclusions-IUS delivered reliable results for clinically important small intestinal stenosis of CD with high diagnostic accuracy.

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Impact of intestinal ultrasound on the management of patients with inflammatory bowel disease: how to apply scientific evidence to clinical practice

Cited by 27 publications

References 82 publications

Covid-19 and the management of patients with inflammatory bowel disease: a practical decalogue for the post-pandemic phase

Covid-19 and the management of patients with inflammatory bowel disease: a practical decalogue for the post-pandemic phase

Bowel Ultrasound in Inflammatory Bowel Disease: How Far in the Grayscale?

Usefulness of Intestinal Ultrasound to Detect Small Intestinal Stenosis in Patients With Crohn's Disease

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