Intestinal ultrasound (IUS) is an accurate and non-invasive tool to assess disease activity in inflammatory bowel disease (IBD). IUS is now increasingly used in Australia as a method to monitor inflammation in IBD as it offers significant advantages over our current tools.
Faecal calprotectin and CRP are useful biomarkers in measuring inflammation but do not give us information about the location and extent of disease. Repeated colonoscopy is a significant burden to the patient in that it is an invasive test and requires bowel preparation and sedation.
In contrast, IUS can be performed with the patient awake and there is no bowel preparation or fasting required! Both the small bowel and colon are visualised and the key markers of inflammation are increased bowel wall thickness and colour Doppler signal. Other signs of active IBD include loss of bowel wall stratification, lymphadenopathy and complications such as strictures and abscesses.
1FIGURE 1: Inflamed terminal ileum with increased bowel wall thickness (BWT) and intact stratification (left), normal BWT terminal ileum (right)
IUS is an useful test and can be repeated in patients to monitor response to treatment.
Dr Nina Parthasarathy performs IUS at Northern Health.
- Maaser C, Maconi G, Kucharzik T, Allocca M. Ultrasonography in inflammatory bowel disease –So far we are? United European Gastroenterol J.2022;10(2):225–32. https://doi.org/10.1002/ueg2.12196 ↩︎
