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Utility of Intestinal Ultrasound in Clinical Decision-Making for Inflammatory Bowel Disease

BACKGROUND: There is a clinical need to improve the monitoring of inflammatory bowel disease (IBD) activity. Despite being used regularly in European countries, intestinal ultrasound (IUS) has been implemented less in the United States for unclear reasons. AIMS: The aim of this study is to illustrat...

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Autores principales: Saleh, Adam, Abraham, Bincy P
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10246583/
https://www.ncbi.nlm.nih.gov/pubmed/37292105
http://dx.doi.org/10.1093/crocol/otad027
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author Saleh, Adam
Abraham, Bincy P
author_facet Saleh, Adam
Abraham, Bincy P
author_sort Saleh, Adam
collection PubMed
description BACKGROUND: There is a clinical need to improve the monitoring of inflammatory bowel disease (IBD) activity. Despite being used regularly in European countries, intestinal ultrasound (IUS) has been implemented less in the United States for unclear reasons. AIMS: The aim of this study is to illustrate how IUS can be used as a clinical decision-making tool in an American IBD cohort. METHODS: This retrospective cohort analysis evaluated patients with IBD seen at our institution who underwent IUS as part of routine evaluation of their IBD from July 2020 to March 2022. To evaluate the clinical utility of IUS for different patient populations and against more frequently used measures of inflammation, we compared patient demographics, inflammatory markers, clinical scores, and medications between patients in remission and those with active inflammation. Treatment plans between the 2 groups were compared and we analyzed patients with follow-up IUS visits to validate treatment plan decisions at initial evaluation. RESULTS: Out of 148 total patients with IUS, we found that 62.1% (N = 92) of our patients had active disease and 37.9% (N = 56) were in remission. Ulcerative colitis activity index and Mayo scores were both significantly correlated with IUS findings. The treatment plan was significantly correlated with IUS findings (P = .004). At follow-up, we observed an overall decrease in intestinal thickening, improvements in vascular flow, and mural stratification. CONCLUSIONS: Clinical decisions incorporating IUS findings effectively reduced inflammation in our IBD patients. IUS should be strongly considered by IBD clinicians in the United States for monitoring disease activity in IBD.
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spelling pubmed-102465832023-06-08 Utility of Intestinal Ultrasound in Clinical Decision-Making for Inflammatory Bowel Disease Saleh, Adam Abraham, Bincy P Crohns Colitis 360 Observations and Research BACKGROUND: There is a clinical need to improve the monitoring of inflammatory bowel disease (IBD) activity. Despite being used regularly in European countries, intestinal ultrasound (IUS) has been implemented less in the United States for unclear reasons. AIMS: The aim of this study is to illustrate how IUS can be used as a clinical decision-making tool in an American IBD cohort. METHODS: This retrospective cohort analysis evaluated patients with IBD seen at our institution who underwent IUS as part of routine evaluation of their IBD from July 2020 to March 2022. To evaluate the clinical utility of IUS for different patient populations and against more frequently used measures of inflammation, we compared patient demographics, inflammatory markers, clinical scores, and medications between patients in remission and those with active inflammation. Treatment plans between the 2 groups were compared and we analyzed patients with follow-up IUS visits to validate treatment plan decisions at initial evaluation. RESULTS: Out of 148 total patients with IUS, we found that 62.1% (N = 92) of our patients had active disease and 37.9% (N = 56) were in remission. Ulcerative colitis activity index and Mayo scores were both significantly correlated with IUS findings. The treatment plan was significantly correlated with IUS findings (P = .004). At follow-up, we observed an overall decrease in intestinal thickening, improvements in vascular flow, and mural stratification. CONCLUSIONS: Clinical decisions incorporating IUS findings effectively reduced inflammation in our IBD patients. IUS should be strongly considered by IBD clinicians in the United States for monitoring disease activity in IBD. Oxford University Press 2023-05-15 /pmc/articles/PMC10246583/ /pubmed/37292105 http://dx.doi.org/10.1093/crocol/otad027 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Observations and Research
Saleh, Adam
Abraham, Bincy P
Utility of Intestinal Ultrasound in Clinical Decision-Making for Inflammatory Bowel Disease
title Utility of Intestinal Ultrasound in Clinical Decision-Making for Inflammatory Bowel Disease
title_full Utility of Intestinal Ultrasound in Clinical Decision-Making for Inflammatory Bowel Disease
title_fullStr Utility of Intestinal Ultrasound in Clinical Decision-Making for Inflammatory Bowel Disease
title_full_unstemmed Utility of Intestinal Ultrasound in Clinical Decision-Making for Inflammatory Bowel Disease
title_short Utility of Intestinal Ultrasound in Clinical Decision-Making for Inflammatory Bowel Disease
title_sort utility of intestinal ultrasound in clinical decision-making for inflammatory bowel disease
topic Observations and Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10246583/
https://www.ncbi.nlm.nih.gov/pubmed/37292105
http://dx.doi.org/10.1093/crocol/otad027
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