scholarly journals Role of Intestinal Ultrasound in the Management of Patients with Inflammatory Bowel Disease

Life ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 603
Author(s):  
Aranzazu Jauregui-Amezaga ◽  
Jordi Rimola
Keyword(s):  
Bowel Wall ◽  
Imaging Techniques ◽  
Daily Practice ◽  
Wall Thickening ◽  
Free Fluid ◽  
Non Invasive ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Standardized Parameters ◽  
The Cost

Intestinal ultrasound (IUS) has gained popularity as a first line technique for the diagnosis and monitoring of patients with inflammatory bowel diseases (IBD) due to its many advantages. It is a non-invasive imaging technique with non-ionizing radiation exposure. It can be easily performed not only by radiologists but also by trained gastroenterologists at outpatient clinics. In addition, the cost of IUS equipment is low when compared with other imaging techniques. IUS is an accurate technique to detect inflammatory lesions and complications in the bowel in patients with suspected or already known Crohn’s disease (CD). Recent evidence indicates that IUS is a convenient and accurate technique to assess extension and activity in the colon in patients with ulcerative colitis (UC), and can be a non-invasive alternative to endoscopy. In patients with IBD, several non-specific pathological ultrasonographic signs can be identified: bowel wall thickening, alteration of the bowel wall echo-pattern, loss of bowel stratification, increased vascularization, decreased bowel peristalsis, fibro-fatty proliferation, enlarged lymph nodes, and/or abdominal free fluid. Considering the transmural CD inflammation, CD complications such as presence of strictures, fistulae, or abscesses can be detected. In patients with UC, where inflammation is limited to mucosa, luminal inflammatory ultrasonographic changes are similar to those of CD. As the technique is related to the operator’s experience, adequate IUS training, performance in daily practice, and a generalized use of standardized parameters will help to increase its reproducibility.

scholarly journals Rediscovering histology: what is new in endoscopy for inflammatory bowel disease?

2021 ◽  
Vol 14 ◽  
pp. 175628482110056
Author(s):  
Virginia Solitano ◽  
Ferdinando D’Amico ◽  
Mariangela Allocca ◽  
Gionata Fiorino ◽  
Alessandra Zilli ◽  
...  
Keyword(s):  
Disease Activity ◽  
Narrow Band Imaging ◽  
Daily Practice ◽  
Cancer Surveillance ◽  
Special Focus ◽  
High Expectations ◽  
Endoscopic Techniques ◽  
Bowel Diseases ◽  
Inflammatory Bowel

The potential of endoscopic evaluation in the management of inflammatory bowel diseases (IBD) has undoubtedly grown over the last few years. When dealing with IBD patients, histological remission (HR) is now considered a desirable target along with symptomatic and endoscopic remission, due to its association with better long-term outcomes. Consequently, the ability of endoscopic techniques to reflect microscopic findings in vivo without having to collect biopsies has become of upmost importance. In this context, a more accurate evaluation of inflammatory disease activity and the detection of dysplasia represent two mainstay targets for IBD endoscopists. New diagnostic technologies have been developed, such as dye-less chromoendoscopy, endomicroscopy, and molecular imaging, but their real incorporation in daily practice is not yet well defined. Although dye-chromoendoscopy is still recommended as the gold standard approach in dysplasia surveillance, recent research questioned the superiority of this technique over new advanced dye-less modalities [narrow band imaging (NBI), Fuji intelligent color enhancement (FICE), i-scan, blue light imaging (BLI) and linked color imaging (LCI)]. The endoscopic armamentarium might also be enriched by new video capsule endoscopy for monitoring disease activity, and high expectations are placed on the application of artificial intelligence (AI) systems to reduce operator-subjectivity and inter-observer variability. The goal of this review is to provide an updated insight on contemporary knowledge regarding new endoscopic techniques and devices, with special focus on their role in the assessment of disease activity and colorectal cancer surveillance.

scholarly journals Imaging in Inflammatory Bowel Diseases - Magnetic Resonance Imaging

2015 ◽  
Vol 33 (Suppl. 1) ◽  
pp. 26-31
Author(s):  
Hans Herfarth ◽  
Andreas G. Schreyer
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Intestinal Inflammation ◽  
Imaging Modality ◽  
Imaging Techniques ◽  
Magnetization Transfer ◽  
Diagnostic Value ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Line Imaging ◽  
Sensitivity Specificity

Diagnostic imaging techniques play an important role in the diagnosis and management of patients with inflammatory bowel diseases (IBDs). The approach should be guided by considerations of diagnostic accuracy, concerns about patient exposure to ionizing radiation, local expertise and tolerance of the endoscopic and/or imaging technique. In regard to the clinical diagnostic value (sensitivity, specificity and accuracy), no significant differences exist between CT and MRI for the evaluation of the extent of inflammation, stricturing, penetrating disease or extraluminal complications such as abscesses. Due to the absence of radiation exposure, MRI of the intestine is recommended as the first-line imaging modality in patients with suspected or established IBD. The focus of this review is the latest developments in MRI techniques to detect IBDs. Specifically, the use of new indices for the grading of inflammation or assessing bowel damage as well as innovative experimental approaches such as diffusion-weighted imaging or magnetization-transfer MRI to evaluate and quantify the degree of intestinal inflammation and fibrosis in stricturing Crohn's disease are discussed.

Developing a Model to Study Commensal Translocation during IBD

2018 ◽  
Author(s):  
Kathy Yu
Keyword(s):  
Bacterial Translocation ◽  
Imaging Techniques ◽  
Coli Strain ◽  
The Body ◽  
Conjugation System ◽  
E Coli ◽  
Normal Microbiota ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Future Work

Inflammatory bowel diseases (IBD) is severe inflammation of the gastrointestinal tract. This can lead to a breakdown of mucosal barriers, causing dissemination of commensal bacteria throughout the body. To better understand bacterial translocation during IBD, aim to develop a fluorescent microbiota in mice that we can interrogate using live imaging techniques.   Our preliminary experiments depleted commensals using broad-spectrum antibiotics,  and replaced these microbiota with a fluorescent E. coli strain. The length of time that E.coli stays in the mice gut were monitored. We show that E. coli can persist in the ‘germ-free’ mouse gut for at least 21 days; control mice lose all added E. coli by 8-14 days. The establishment of the E. coli colony suggests this could be a reasonable model to study bacterial translocation.  We are currently going to treat the colonized mice with DSS to induce colitis, and then to study translocation of E. coli by intravital microscopy. Considering E. coli is only a fraction of the normal microbiota and perhaps not a relevant model, future work aims at making a fluorescent microbiota consisting of multiple endogenous murine microbes. This will entail the use of a bacterial conjugation system  capable of ubiquitously transforming many microbial species.  

scholarly journals P211 Pseudopolyps are associated with increased fecal calprotectin levels in patients with Inflammatory Bowel Disease in clinical and endoscopic remission

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S270-S271
Author(s):  
I Spigarelli De Rábago ◽  
C Suárez Ferrer ◽  
J Poza Cordón ◽  
E Martín Arranz ◽  
M Sánchez Azofra ◽  
...  
Keyword(s):  
Fecal Calprotectin ◽  
Clinical Settings ◽  
Optimal Cutoff ◽  
Non Invasive ◽  
Endoscopic Remission ◽  
Active Colitis ◽  
Bowel Diseases ◽  
Endoscopic Score ◽  
Inflammatory Bowel ◽  
Histological Activity

Abstract Background Fecal calprotectin (FC) has become a fundamental tool in the non-invasive monitorization of activity in patients with inflammatory bowel diseases (IBD). However, there is still debate over the choice of the optimal cut-off point for the different clinical settings. The aim of this study is to analyze whether the presence of pseudopolyps and their characteristics have an impact on the value of FC and should therefore be taken into account when deciding the optimal cutoff values. Methods A single-centered, retrospective analysis including data from patients with colonic Crohn′s disease or Ulcerative colitis who underwent colonoscopy for dysplasia screening at our center between 2018 and 2019. Patients that did not have a FC registered within 8 months from to the colonoscopy, or that did not maintain clinical remission between the colonoscopy and the measurement of the FC, were excluded. Patients that had activity in the colonoscopy (Mayo endoscopic score >0, SESCD >0) were also excluded. Results 73 patients were included. 26 (35.6%) of them had pseudopolyps in the colonoscopy. The median value of the FC was significantly different in patients with pseudopolyps (110.1 µg/g, CI 95% [48.6–171.5]) compared to those without them (52.5 µg/g, CI 95% [29.9–75.1]). In 11 (42.3%) of the patients with pseudopolyps, biopsies were taken, observing histological activity in 3 of them (27.3%) and no inflammatory activity in the other 8 (72.7%). We found that FC was higher in patients with inflammatory polyps (119.0 µg/g) in comparison to those without histological activity in their pseudopolyps (96.9 µg/g); however, these results were not statistically significant. The location of the pseudopolyps had no influence over the FC in our study. In addition, no correlation was found between the presence of polyps or diverticula and FC. Conclusion In our study, the presence of pseudopolyps is associated with significantly higher levels of FC. Moreover, our results suggest a tendency towards higher FC in patients who had active colitis in the histological samples of their pseudopolyps.

scholarly journals New Metabolic and Genetic Biomarkers for Diagnosis of Ulcerative Colitis

2021 ◽  
Author(s):  
Elena Emilia Tudoroniu ◽  
Mihaela Andreea Costache ◽  
Maria-Andreea Stancu ◽  
Anca Lucia Pop
Keyword(s):  
Ulcerative Colitis ◽  
Case Series ◽  
Diagnostic Value ◽  
Eligibility Criteria ◽  
Non Invasive ◽  
Randomized Controlled ◽  
Genetic Biomarkers ◽  
Bowel Diseases ◽  
Invasive Method ◽  
Inflammatory Bowel

Ulcerative colitis (UC) is one of the two disorders known as inflammatory bowel diseases (IBD) along with Crohn’s disease (CD), with complex pathogenesis, requiring costly invasive investigations. Objective: to examine the most recent biomarkers proposed for UC diagnosis; to establish the strategy used to make the differential diagnosis between UC and CD relying on these biomarkers, also adding the benefit of finding new non-invasive tools in managing this condition. The search was performed in a single database (Web of Science) using the specific keywords „ulcerative colitis”, „biomarkers” and „diagnosis” for the last five years. Study eligibility criteria: clinical trials on adults and pediatric patients with ulcerative colitis compared with Crohn’s disease. Results: We selected 57 studies, randomized controlled trials (RCTs) and clinical case series (CCS), summarizing the latest most specific biomarkers in diagnosis of UC. Limitations: we considered RCTs and CCS from one database, limited to the search topics. Our findings indicate a important number of potential biomarkers with diagnostic value, which bring the advantage of a non-invasive method to approach this challenging disorder.

P162 RAID-Monitor: a new non-invasive method to determine endoscopic activity in inflammatory bowel diseases

2019 ◽  
Vol 13 (Supplement_1) ◽  
pp. S169-S170
Author(s):  
J Amoedo ◽  
S Ramió-Pujol ◽  
A Bahí ◽  
C Puig-Amiel ◽  
L Oliver ◽  
...  
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Non Invasive ◽  
Bowel Diseases ◽  
Invasive Method ◽  
Inflammatory Bowel

scholarly journals Practical guidance on the use of faecal calprotectin

2017 ◽  
Vol 9 (2) ◽  
pp. 87-91 ◽  
Author(s):  
Matthew J Brookes ◽  
Simon Whitehead ◽  
Daniel R Gaya ◽  
Antony Barney Hawthorne
Keyword(s):  
Disease Diagnosis ◽  
Evidence Base ◽  
Current Evidence ◽  
Faecal Calprotectin ◽  
Non Invasive ◽  
Mucosal Disease ◽  
Current Evidence Base ◽  
Inflammatory Bowel ◽  
The Cost

Differentiation between inflammatory bowel disease (IBD) and functional gut disorders, and the determination of mucosal disease activity in established cases of IBD remain the cornerstones of disease diagnosis and management. Non-invasive, accurate biomarkers of gut inflammation are needed due to the variability of symptoms, the inaccuracies of currently available blood markers and the cost and invasive nature of endoscopy. Numerous biomarkers have been used and/or considered with some in current use. This article reviews the current evidence base around the indications for using biomarkers and their limitations, with a particular focus on faecal calprotectin.

Particularities of IBD Trials in Children

2019 ◽  
Vol 25 (1) ◽  
pp. 69-72 ◽  
Author(s):  
Dan Turner
Keyword(s):  
Recent Trend ◽  
Safety Data ◽  
New Drugs ◽  
Phase 3 ◽  
Non Invasive ◽  
Randomized Controlled ◽  
Adult Phase ◽  
Bowel Diseases ◽  
Pediatric Trial ◽  
Inflammatory Bowel

Pediatric inflammatory bowel diseases (IBD) are similar to the adult-onset type in many aspects, including the necessity of high-quality randomized controlled trials. However, recruiting children into clinical trials is conceptually more challenging than in adults. Furthermore, the long delay between adult and pediatric approval of new drugs leads not only to the unbearable extensive use of these drugs as off-label without appropriate dosing and safety data but also to more challenges when eventually the pediatric trial is performed. This review offers possible solutions to age-specific pitfalls in performing trials in pediatric IBD. Many of the challenges could be adequately addressed by accepting full extrapolation of efficacy from adult trials. This is advisable if small pharmacokinetics/ pharmacodynamics (PK/PD) studies show similarity to adult data. Then, pediatric trials can focus on dosing and safety while avoiding the controversial use of placebo. Judicious use of non-invasive activity scores and biomarkers, providing immediate and effective treatment in active disease and ensuring equipoise of treatments both within and outside the trial are the mainstay of a feasible trial in children. The recent trend of including adolescents in adult phase-3 trials addresses some obstacles but introduces others. Acknowledging and addressing these age-specific challenges would facilitate pediatric drug development in IBD.

scholarly journals Ultrasound of the Small Bowel in Crohn’s Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Emma Calabrese ◽  
Francesca Zorzi ◽  
Francesco Pallone
Keyword(s):  
Crohn’S Disease ◽  
Gastrointestinal Tract ◽  
Crohn's Disease ◽  
Imaging Techniques ◽  
Careful Evaluation ◽  
Intravenous Contrast ◽  
Endoscopic Techniques ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Exciting Area

Several radiological and endoscopic techniques are now available for the study of inflammatory bowel diseases. In everyday practice, the choice of the technique to be used depends upon its availability and a careful evaluation of diagnostic accuracy, clinical usefulness, safety, and cost. The recent development of innovative and noninvasive imaging techniques has led to a new and exciting area in the exploration of the gastrointestinal tract, especially in Crohn’s disease patients by using ultrasound with oral or intravenous contrast.

scholarly journals Up-to-date overview of imaging techniques in the diagnosis and management of inflammatory bowel diseases

2019 ◽  
Vol 14 (1) ◽  
pp. 19-25
Author(s):  
Katarzyna B. Biernacka ◽  
Dobromiła Barańska ◽  
Piotr Grzelak ◽  
Elżbieta Czkwianianc ◽  
Katarzyna Szabelska-Zakrzewska
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Imaging Techniques ◽  
Diagnosis And Management ◽  
Bowel Diseases ◽  
Inflammatory Bowel
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