ASGE guideline: Endoscopy in the diagnosis and treatment of inflammatory bowel disease

Jonathan A Leighton, Bo Shen, Todd H. Baron, Douglas G. Adler, Raquel Davila, James V. Egan, Douglas Orrick Faigel, Seng Ian Gan, William K. Hirota, David Lichtenstein, Waqar A. Qureshi, Elizabeth Rajan, Marc J. Zuckerman, Trina VanGuilder, Robert D. Fanelli

Research output: Contribution to journalArticle

165 Citations (Scopus)

Abstract

Colonoscopy with ileoscopy should be performed in the evaluation of IBD and for differentiating UC from CD (B). Mucosal biopsy specimens are important for the diagnosis of IBD and may help differentiate CD from UC (B). When colonoscopy is contraindicated, or the extent of disease is limited, flexible sigmoidoscopy may provide an adequate diagnosis (C). EGD or enteroscopy may be helpful for diagnosing IBD when other studies have negative results and for differentiating CD from UC in indeterminate colitis (B). CE is a less invasive technique for evaluating the small intestine for Crohn's involvement and has been shown to be more sensitive than radiologic and endoscopic procedures for detecting small bowel lesions (B). In patients with CD and known or suspected high-grade strictures, CE should not be performed (C). Small bowel follow-through or CT enterography should be obtained before CE in patients with CD to assess for high-grade strictures (C). CRC risk is increased in both UC and extensive Crohn's colitis and surveillance colonoscopy with multiple biopsies should be performed every 1 to 2 years beginning after 8 to 10 years of disease (B). The finding of dysplasia in flat mucosa, especially if multifocal, is an indication for total colectomy (B). Colectomy is indicated for colorectal cancer, high-grade dysplasia or low-grade dysplasia (particularly multifocal) in flat mucosa. A dysplastic mass lesion that cannot be removed endoscopically, or is associated with dysplasia elsewhere in the colon, is an indication for total colectomy (B). Dysplastic polypoid lesions may be managed as sporadic adenomas provided they are completely resected and there is no dysplasia in flat mucosa surrounding the polyp or elsewhere in the colon (B). EUS is highly accurate for characterizing perianal Crohn's disease (C). A colonic stricture in the setting of UC should be considered malignant until proven otherwise. If adequate evaluation cannot be performed, then colectomy is indicated (C). Chronic benign fibrotic strictures associated with obstructive symptoms may be managed with endoscopic balloon dilation with or without steroid injections (B).

Original languageEnglish (US)
Pages (from-to)558-565
Number of pages8
JournalGastrointestinal Endoscopy
Volume63
Issue number4
DOIs
StatePublished - Apr 2006

Fingerprint

Colectomy
Inflammatory Bowel Diseases
Endoscopy
Pathologic Constriction
Colonoscopy
Guidelines
Mucous Membrane
Colitis
Colon
Biopsy
Sigmoidoscopy
Therapeutics
Polyps
Crohn Disease
Adenoma
Small Intestine
Dilatation
Colorectal Neoplasms
Steroids
Injections

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Leighton, J. A., Shen, B., Baron, T. H., Adler, D. G., Davila, R., Egan, J. V., ... Fanelli, R. D. (2006). ASGE guideline: Endoscopy in the diagnosis and treatment of inflammatory bowel disease. Gastrointestinal Endoscopy, 63(4), 558-565. https://doi.org/10.1016/j.gie.2006.02.005

ASGE guideline : Endoscopy in the diagnosis and treatment of inflammatory bowel disease. / Leighton, Jonathan A; Shen, Bo; Baron, Todd H.; Adler, Douglas G.; Davila, Raquel; Egan, James V.; Faigel, Douglas Orrick; Gan, Seng Ian; Hirota, William K.; Lichtenstein, David; Qureshi, Waqar A.; Rajan, Elizabeth; Zuckerman, Marc J.; VanGuilder, Trina; Fanelli, Robert D.

In: Gastrointestinal Endoscopy, Vol. 63, No. 4, 04.2006, p. 558-565.

Research output: Contribution to journalArticle

Leighton, JA, Shen, B, Baron, TH, Adler, DG, Davila, R, Egan, JV, Faigel, DO, Gan, SI, Hirota, WK, Lichtenstein, D, Qureshi, WA, Rajan, E, Zuckerman, MJ, VanGuilder, T & Fanelli, RD 2006, 'ASGE guideline: Endoscopy in the diagnosis and treatment of inflammatory bowel disease', Gastrointestinal Endoscopy, vol. 63, no. 4, pp. 558-565. https://doi.org/10.1016/j.gie.2006.02.005
Leighton, Jonathan A ; Shen, Bo ; Baron, Todd H. ; Adler, Douglas G. ; Davila, Raquel ; Egan, James V. ; Faigel, Douglas Orrick ; Gan, Seng Ian ; Hirota, William K. ; Lichtenstein, David ; Qureshi, Waqar A. ; Rajan, Elizabeth ; Zuckerman, Marc J. ; VanGuilder, Trina ; Fanelli, Robert D. / ASGE guideline : Endoscopy in the diagnosis and treatment of inflammatory bowel disease. In: Gastrointestinal Endoscopy. 2006 ; Vol. 63, No. 4. pp. 558-565.
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