Intestinal Ultrasound for Inflammatory Bowel Diseased Patients Who Receive Biological Treatment

Abstract

Abstract Background Crohn’s disease (CD) and ulcerative colitis (UC) are two forms of chronic inflammatory bowel diseases (IBDs) characterized by recurrent episodes of intestinal inflammation and a heterogeneous range of symptoms and clinical courses. In contrast to CD, UC is a mucosal and to some extent submucosal disease restricted to the colon. Depending on the involved colonic segment, UC can be divided into proctitis, left- sided colitis or extensive colitis. Aim of the Work Prospective evaluation of intestinal ultrasound (iUs) for disease monitoring of patients with ulcerative colitis (Uc) and crhons disease receiving biological treatment with following up the efficacy on intestinal wall. Newly diagnosed patients who will receive biologics and compare with colonoscopy Patients and Methods This was a cohort study in ultrasound unit of gastroenterology department at Ain shams university hospitals, the patients selected from the department of gastroenterology and gastroenterology outpatient clinic from May 2021 till January 2022 on 50 patients. Results When comparing baseline ultrasound results of inflammatory signs and colonoscopy we found non-significant results that support using intestinal ultrasound results as non-invasive tool for diagnosis of inflammatory bowel disease. and also doppler signs it showed significant results in some parts of the colon like terminal ilium, left side, transverse and sigmoid and that is very important in patient who have strictures in terminal ilium prevent terminal ilium intubation during colonoscopy. Also on comparing results of pathology and intestinal ultrasound we found the sensitivity of intestinal ultrasound is very high inflammatory signs 93.8% sensitivity and doppler signs 85.4% but specificity was 50% only that was because it depends on the operators vision and also on the machine used and the patient also he may be not fasting and distended that make the field very hard, also when comparing with ct enterography results and MR enterography it showed the same specificity and sensitivity that confirm our vision also. Conclusion For conclusion intestinal ultrasound one of the best modalities for diagnosis and follow up inflammatory bowel disease, especially in short term response, our finding give rise to not only the assumption of bowel wall thickness but also inflammatory markers, doppler signs, bowel lumen and fibrofatty nodules had significant difference at long term follow up Christian Maaser et al findings give rise to the assumption that monitoring BWT alone has the potential to predict therapeutic response. The additional monitoring of FC could add further value in monitoring patients with UC. Future prospective studies are necessary to determine the value of IUS in predicting short and long-term response and outcomes of therapies in UC