The First Endoscopy in Suspected Inflammatory Bowel Disease

Gastrointest Endosc Clin N Am. 2016 Oct;26(4):593-610. doi: 10.1016/j.giec.2016.06.004.

Abstract

In a patient presenting with suspected inflammatory bowel disease, the initial endoscopic evaluation is a valuable tool for determining the correct disease diagnosis and the extent and severity of disease. A full colonoscopy and ileoscopy should be performed when possible, with systematic biopsies from each segment. When a diagnosis of inflammatory bowel disease is established, it is possible to distinguish between Crohn disease and ulcerative colitis, and specific endoscopic features may assist in this categorization. Because patchy healing can occur with treatment, it is important to obtain a thorough and accurate assessment of disease characteristics and distribution before initiating therapy.

Keywords: Backwash ileitis; Colonoscopy; Crohn’s disease; Endoscopy; Ileoscopy; Inflammatory bowel disease; Ulcerative colitis.

Publication types

  • Review

MeSH terms

  • Biopsy
  • Colitis, Ulcerative / diagnosis*
  • Colonoscopy / methods*
  • Crohn Disease / diagnosis*
  • Diagnosis, Differential
  • Endoscopy, Gastrointestinal / methods*
  • Humans
  • Intestines / pathology