Patients who have ulcerative colitis are observed by doctors in order to make sure they adequately manage their disease. Doctors routinely monitor the activity and severity of ulcerative colitis based on endoscopic (visual) and Histologic (using a microscope) assessment. Endoscopy involves using a camera to visualize the gastrointestinal tract. Histology involves looking at cells under a microscope to see what is present – and more importantly, if anything abnormal presents.

The use of endoscopy and histology to evaluate ulcerative colitis has historically been independent of one another, but there is a need to correlate what doctors see in endoscopy and what they see in histology. One of these methods may be better than the other, or they could complement each other to give doctors and patients better information.

The study:

  • 263 sets (samples of gastrointestinal system) from patients with ulcerative colitis were reviewed by an experienced gastrointestinal pathologist and scored.
  • Endoscopic scoring had been performed previously by inflammatory bowel disease specialists.  A comparison of endoscopic and histologic scores was then conducted.
  • It was found that the histologic and endoscopic activity scores neatly correlate (agree with one another)
  • It was noted that histology may detect more severe disease than does endoscopy, which would affect the clinical management of that patient.

The conclusions:

  • From this study, it can be suggested that histologic scoring should be used in addition to endoscopy when scoring disease activity for clinical trials.


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