Evolving diagnostic strategies for inflammatory bowel disease

David H Bruining, Edward Vincent Loftus, Jr

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Advances in serologic markers, endoscopy, and radiology have led to rapid expansion of diagnosis and disease activity assessment of inflammatory bowel disease (IBD). Serologic markers may have diagnostic value in patients with an intermediate pretest probability of IBD, but these serology tests lack complete sensitivity, and a negative serology result does not exclude the possibility of IBD. Several recent studies have confirmed the utility of serologies in predicting intestinal complications and need for surgery in Crohn's disease. Serum C-reactive protein concentrations correlate with clinical, endoscopic, and radiologic measures of disease activity and appear to have prognostic value in acute severe colitis. Capsule and double balloon endoscopy allow visual inspection of previously inaccessible areas of the small intestine and are useful for patients with suspected small bowel involvement but negative results on conventional testing. CT enterography, which entails oral ingestion of a large volume of a neutral or negative contrast agent and scanning that highlights differences in contrast between the lumen and the bowel wall, appears to be more sensitive than small bowel follow-through for detecting small bowel Crohn's disease and provides extraluminal information. Magnetic resonance enterography uses principles similar to those for CT enterography, and early results are encouraging.

Original languageEnglish (US)
Pages (from-to)478-485
Number of pages8
JournalCurrent Gastroenterology Reports
Volume8
Issue number6
DOIs
StatePublished - Dec 2006

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Serology
Inflammatory Bowel Diseases
Crohn Disease
Endoscopy
Colitis
Radiology
C-Reactive Protein
Contrast Media
Small Intestine
Capsules
Blood Proteins
Magnetic Resonance Spectroscopy
Eating

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Evolving diagnostic strategies for inflammatory bowel disease. / Bruining, David H; Loftus, Jr, Edward Vincent.

In: Current Gastroenterology Reports, Vol. 8, No. 6, 12.2006, p. 478-485.

Research output: Contribution to journalArticle

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