Abstract
Methods A cross-sectional study was conducted in consecutive newly diagnosed patients with inflammatory bowel disease in a tertiary care referral center. The initial evaluation included patient-reported outcome for stool frequency subscore and rectal bleeding. Endoscopic activity was determined using the Mayo scoring system for ulcerative colitis and the Simple Endoscopic Score for Crohn's disease. Histopathological activity was assessed using a validated numeric scoring system. Results We included 159 patients (63 Crohn's disease with colonic involvement and 96 with ulcerative colitis). We found significant correlation between the Mayo endoscopic subscoring system and histology activity in ulcerative colitis, while no correlation was found in patients with Crohn's disease. Patient-reported outcome showed inverse correlation with endoscopic and histological activity in Crohn's disease (rs = −0.67; rs = −0.72), while positive correlation was found in ulcerative colitis (rs = 0.84; rs = 0.75). Interpretation and Conclusions. Patient-reported outcome is a practical and noninvasive tool for assessment of disease activity in ulcerative colitis patients but not in Crohn's disease.
Highlights
Assessment of inflammatory bowel disease (IBD) activity is necessary in order to determine adequate therapeutic approach for these patients
We found significant correlation between the Mayo endoscopic subscoring system and histology activity in ulcerative colitis, while no correlation was found in patients with Crohn’s disease
Validated patient’s reported outcome (PRO) models contribute to a more comprehensive display of IBD burden establishing discrepancies between clinical symptoms and presence of inflammation determined by colonoscopy or histopathology
Summary
Assessment of inflammatory bowel disease (IBD) activity is necessary in order to determine adequate therapeutic approach for these patients. Active inflammatory bowel disease in both ulcerative colitis (UC) and Crohn’s disease (CD) with colonic involvement includes, as per definition, presence of rectal bleeding (RB) and diarrhoea. We found significant correlation between the Mayo endoscopic subscoring system and histology activity in ulcerative colitis, while no correlation was found in patients with Crohn’s disease. Patient-reported outcome showed inverse correlation with endoscopic and histological activity in Crohn’s disease (rs = −0:67; rs = −0:72), while positive correlation was found in ulcerative colitis (rs = 0:84; rs = 0:75). Patient-reported outcome is a practical and noninvasive tool for assessment of disease activity in ulcerative colitis patients but not in Crohn’s disease
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