Intestinal ultrasound can differentiate organic from functional bowel disease

LONDON (Reuters Health) – Italian investigators suggest that, in the absence of signs or symptoms of an organic disorder, intestinal ultrasound should be used as a screening tool in patients with abdominal pain and irregular bowel habits before radiography or endoscopy is considered.

In 313 younger adults, mean age 36, with symptom duration of more than 3 months, intestinal ultrasound was used to analyze bowel-wall thickness. Dr. Marco Astegiano, of Azienda Ospedaliera San Giovanni Battista in Torino, and colleagues set a 7-mm thickness as the cutoff for inflammatory bowel disease.

Based on followup testing, 75% of patients were diagnosed with irritable bowel syndrome, 20% with Crohn's disease, and 5% with ulcerative colitis, the researchers report in the European Journal of Gastroenterology and Hepatology for August.

Ultrasound results were positive in 84% of patients with Crohn's disease, 38% of those with ulcerative colitis and 2% of those with irritable bowel syndrome. The sensitivity of intestinal ultrasound for inflammatory bowel disease was estimated to be 74%, with specificity of 98% and a positive predictive value of 92%. For Crohn's disease the sensitivity was 84% and the positive predictive value was 91%.

The authors suggest that a cut-off value of 7 mm is better than 5 mm in differentiating inflammatory bowel disease from irritable bowel syndrome.

"Using intestinal ultrasound, an indication of disease location is possible, which allows the most appropriate subsequent instrumental examinations to be chosen," Dr. Astegiano's team remarks.

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