The Role of Ultrasound in the Evaluation of Inflammatory Bowel Disease

Abstract

Inflammatory Bowel Disease (IBD) is a chronic, systemic immune-mediated disorder of the bowel. It comprises 2 main disorders: Crohn’s disease (CD) and ulcerative colitis (UC), with a third, less common entity—IBD undifferentiated—having features of both CD and UC. The global incidence and prevalence of these disorders are increasing over time, with the highest rates seen in Canada and northern Europe. 1 Chronic relapsing, remitting intestinal inflammation characterizes IBD, with manifestations both inside and outside of the gastrointestinal tract. Patients are affected early in life, with onset in childhood in over 25%-30% of cases, with the peak in diagnosis between the ages of 15 and 30 years. 2,3 This often leads to the need for long-term diseasemanagement and medication.Caring forpatientswith CD IBD is thus very expensive, with the potential for significant effect on quality of life and productivity. 4,5 Early detection of disease activity is key to medical management, so that timely intervention may reduce disease symptoms and morbidity, including hospitalization and surgery. CD is characterized by transmural inflammation, present in anasymmetricorskiplesiondistribution,withpredilectionfor thesmallbowel;however,diseasemayaffectanyportionofthe gastrointestinal tract. Diarrhea, abdominal pain, weight loss, and fatigue are the most commonly associated symptoms. Some patients remain totally asymptomatic, even with extensive disease, but most patients have an insidious course of progressive inflammation. 6 As a result of the transmurality of