Colitis Patients May Not Always Need Endoscopy

Patients' Reports, Blood Tests May Help Track the Disease Instead

Reviewed by Brunilda Nazario, MD on January 25, 2005
From the WebMD Archives

Jan. 25, 2005 -- People with ulcerative colitisulcerative colitis may not always need endoscopy to monitor the disease. Instead, blood tests and a person's self-reported symptoms could be enough.

With ulcerative colitis, a trigger causes uncontrolled inflammation and damage of the large intestine. Symptoms of the disease wax and wane over a lifetime and can include diarrhea, rectal bleeding, and abdominal pain.

However, researchers have questioned whether a flare-up of symptoms requires the expense and discomfort of endoscopy.

The new study comes from University of Michigan researchers including Peter D.R. Higgins, MD, PhD. It appears in The American Journal of Gastroenterology's February edition.

Higgins and colleagues studied 66 people with ulcerative colitis.

In endoscopy, a thin, flexible, lighted tube with a camera is guided through the rectum to examine the intestine. It's similar to colonoscopy, which checks for signs of colon cancer. But in endoscopy, the scope doesn't go as far into the colon as in colonoscopy.

Endoscopy works. It's necessary to diagnose colitis, check for the extent of the disease, and evaluate colitis that doesn't respond to therapy. It can also be used to gather tissue for biopsies to help guide therapy, say the researchers.


But is endoscopy worth the discomfort and expense in established colitis cases?

To find out, participants gave blood samples, underwent endoscopy, and answered 50 questions about their colitis, including stool frequency and blood in stools.

The results showed that endoscopy didn't provide much new information. Virtually all of the same details were available from blood tests and patients' reports.

"Our data suggest that these endoscopies may not have added significantly to the measurement of disease activity, and they likely added significantly to study costs and subject discomfort," write the researchers.

If the results of this study are validated, blood tests and patient reports may reduce endoscopy use. That could make colitis patients more comfortable and willing to get medical care or join studies, say the researchers. Since endoscopy is more expensive than these other tests, the finding might also lead to lower costs for colitis care and research.

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SOURCES: Higgins, P. The American Journal of Gastroenterology, February 2005; vol 100: pp 1-7. WebMD Medical Reference from Healthwise: "Ulcerative Colitis Topic Overview." WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Digestive Diseases: Endoscopy." News release, University of Michigan.
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