Related Experiment Video
Updated: Feb 22, 2026
Flexible Colonoscopy in Mice to Evaluate the Severity of Colitis and Colorectal Tumors Using a Validated Endoscopic Scoring System
Published on: October 16, 2013
Endoscopic and Histological Assessment of Paediatric Inflammatory Bowel Disease Over a 3-Year Follow-up Period
James J Ashton1,2, Quentin Bonduelle1, Enrico Mossotto2
1Department of Paediatric Gastroenterology, Southampton Children's Hospital.
Insights
Histological disease extent in Crohn's disease (CD) exceeds endoscopic extent throughout the disease course. Classification of CD extent should integrate both endoscopic and histological findings for accurate patient management.
Area of Science:
- Gastroenterology
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
Background:
- Discrepancies between endoscopic and histological assessments of inflammatory bowel disease (IBD) extent are noted at diagnosis.
- The persistence of these discrepancies throughout the disease course and their impact on classification and management remain unclear.
Purpose of the Study:
- To analyze the progression of IBD disease extent over a 3-year period.
- To investigate whether endoscopic and histological disease extents diverge during the disease course in pediatric IBD patients.
Main Methods:
- A cohort of pediatric patients (<17 years) diagnosed with IBD between 2010-2013 were followed for 3 years.
- Disease extent was assessed via endoscopy and histology at diagnosis and follow-up, utilizing the Paris Classification (PC).
- Changes in disease extent and classification were analyzed, comparing endoscopic and histological data.
Main Results:
- Histological disease extent remained significantly greater than endoscopic extent in Crohn's disease (CD) patients throughout the 3-year follow-up.
- Endoscopic and histological extents matched in ulcerative colitis (UC) and IBD unclassified (IBDU) patients.
- Modified Paris Classification based on histology significantly altered CD staging, particularly for upper gastrointestinal involvement.
Conclusions:
- Histological assessment provides a more comprehensive measure of disease extent in CD compared to endoscopy alone, both at diagnosis and during follow-up.
- For accurate classification and management of CD, integrating both endoscopic and histological criteria is essential.
- In UC and IBDU, endoscopic and histological extents align, suggesting current classification methods may suffice.
Objectives:
Discrepancies between inflammatory bowel disease (IBD) endoscopic/histological extent are documented at diagnosis. It is unclear whether these differences persist through disease course, with potential impact on categorization and management. We aimed to analyze the progression of disease over a 3-year period.
Methods:
Patients younger than 17 years, diagnosed between 2010 and 2013 at Southampton Children's Hospital and followed-up for 3 years were eligible. Primary outcome was disease extent at diagnosis and follow-up. Data are presented as percentage of patients undergoing endoscopy. Paris classification (PC) and PC using histological, rather than endoscopic disease, were determined.
Results:
One hundred and twenty-five patients were included, 66 boys; Crohn's disease (CD) 74, ulcerative colitis (UC) 40, IBD unclassified (IBDU) 11. All had endoscopy at diagnosis. One hundred and two patients underwent ≥1 repeat endoscopies.Disease extent reduced from diagnosis to first follow-up endoscopy for both endoscopic and histological disease extent (CD/UC/IBDU, all P < 0.00006). Histological extent remained greater than endoscopic in CD with significant differences in stomach, ileum, and large bowel at all follow-up points (P = < 0.045). Endoscopic matched histological extent in UC/IBDU. Applying a modified PC resulted in significant changes for CD (L3 27.4%-53.2%, P = 0.006, L3 + L4A 21%-50%, P = 0.001, and upper gastrointestinal disease 50%-80.6%, P = 0.0006) but not UC. CD height (-0.37 to -0.25) and weight (-1.09 to -0.19) standard deviation scores increased from diagnosis to follow-up.
Conclusions:
Histological disease is greater than endoscopic extent at diagnosis and during follow-up in CD, although not in UC/IBDU. Classification of disease extent in CD should be based on both endoscopic and histological criteria.
More Related Videos
09:50Induction of Intestinal Graft-versus-host Disease and Its Mini-endoscopic Assessment in Live Mice
Published on: February 11, 2019
09:42Murine Endoscopy for In Vivo Multimodal Imaging of Carcinogenesis and Assessment of Intestinal Wound Healing and Inflammation
Published on: August 26, 2014
Related Concept Videos
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.