Intestinal Ultrasound for Ulcerative Colitis

Ulcerative Colitis (UC) is a type of inflammatory bowel disease that affects the large bowel. The causes are not well understood, but the number of patients living with it increases each year. Currently, the gold standard investigation for monitoring UC is through the use of a colonoscopy, which can be invasive as it requires bowel preparation and carries procedural and anesthetic risks from sedation. As a result, it is not practical to repeat colonoscopies frequently to monitor the response to treatment.

Intestinal Ultrasound is a type of ultrasound currently used by gastroenterologists for monitoring Crohn’s disease affecting the small and large bowel. No fasting or bowel preparation is required, and real-time information can be obtained by the ultrasound, which, when combined with patient symptoms and stool inflammation tests (faecal calprotectin), provides an accurate assessment of disease.

A Japanese study published in 2024 with 29 patients with UC investigated if intestinal ultrasound could be directly correlated with the results of a colonoscopy. Patients had the results of their colonoscopy and intestinal ultrasound, which were performed within 15 days, directly compared. The features collected on intestinal ultrasound included bowel wall thickness, bowel blood flow, and fat, which were used to create a score that estimates inflammation. Patients with a higher score for inflammation on intestinal ultrasound had a statistically significant higher score on assessment with colonoscopies. This shows the potential of intestinal ultrasound to reduce the number of colonoscopies required for patients.

Limitations of the study include the small participant size and that it was only performed in one hospital system. This study also did not investigate rectal disease, which is a common area of disease for patients with ulcerative colitis. Despite its promise as a monitoring tool, intestinal ultrasound cannot replace colonoscopies for the diagnosis of Crohn’s disease and ulcerative colitis, as biopsies from the bowels need to be taken.

Any information provided in this article is not intended as medical advice. If you have any concerns or questions, we recommend you discuss them with your doctor.