Role of small-bowel endoscopy in the management of patients with inflammatory bowel disease: An international OMED-ECCO consensus
Bourreille A., Ignjatovic A., Aabakken L., Loftus EV., Eliakim R., Pennazio M., Bouhnik Y., Seidman E., Keuchel M., Albert JG., Ardizzone S., Bar-Meir S., Bisschops R., Despott EJ., Fortun PF., Heuschkel R., Kammermeier J., Leighton JA., Mantzaris GJ., Moussata D., Lo S., Paulsen V., Panés J., Radford-Smith G., Reinisch W., Rondonotti E., Sanders DS., Swoger JM., Yamamoto H., Travis S., Colombel JF., Van Gossum A., Schulz HJ.
Crohns disease and ulcerative colitis are lifelong diseases seen predominantly in the developed countries of the world. Whereas ulcerative coli-tis is a chronic inflammatory condition causing diffuse and continuous mucosal inflammation of the colon, Crohns disease is a heterogeneous -entity comprised of several different phenotypes, but can affect the entire gastrointestinal tract. A change in diagnosis from Crohns disease to ulcer-ative colitis during the first year of illness occurs in about 10%15% of cases. Inflammatory bowel disease (IBD) restricted to the colon that cannot be characterized as either ulcerative colitis or Crohns disease is termed IBD-unclassified (IBDU). The advent of capsule and both single and double-balloon-assisted enteroscopy is revolu-tionizing small-bowel imaging and has major -implications for diagnosis, classification, therapeutic decision making and outcomes in the man-agement of IBD. The role of these investigations in the diagnosis and management of IBD, however, is unclear. This document sets out the current Consensus reached by a group of international -experts in the fields of endoscopy and IBD at a meeting held in Brussels, 1213th December 2008, organised jointly by the European Crohns and Colitis Organisation (ECCO) and the Organisation Mondiale dEndoscopie Digestive (OMED). The Consensus is grouped into seven sections: -definitions and diagnosis; suspected Crohns dis-ease; established Crohns disease; IBDU; ulcera-tive colitis (including ileal pouch-anal anastomosis [IPAA]); paediatric practice; and complications and unresolved questions. Consensus guideline statements are followed by comments on the -evidence and opinion. Statements are intended to be read in context with qualifying comments and not read in isolation. © Georg Thieme Verlag KG Stuttgart.