ILEOSCOPY: WHEN ILEAL EVALUATION IS NOT MANDATORY DURING COLONOSCOPY

Area of Science:

• Gastroenterology
• Endoscopy
• Clinical Diagnostics

Background:

• Ileitis, or inflammation of the ileum, has various causes, including inflammatory bowel disease (IBD).
• Colonoscopic evaluation of the ileum is possible but its routine necessity is debated due to diagnostic yield and procedure time.

Purpose of the Study:

• To assess the correlation between colonoscopic findings of ileitis and clinical indications for the procedure.
• To identify specific clinical scenarios where ileal examination is considered mandatory.

Main Methods:

• Retrospective, cross-sectional study of 3382 patients undergoing ileoscopy between 2013 and 2017.
• Analysis of examination reports, colonoscopy indications, and medical records to determine clinical significance.
• Statistical analysis using odds ratios and 95% confidence intervals to assess associations.

Main Results:

• Ileal alterations were found in 5.3% of patients, with 2.69% considered clinically significant overall (0.96% excluding IBD patients).
• A positive correlation was observed between ileitis findings and IBD control examinations.
• Screening and change in bowel habit indications showed a negative correlation with clinically significant ileitis.

Conclusions:

• Ileal examination is only mandatory in the context of inflammatory bowel disease (IBD) control.
• Ileoscopy is deemed unnecessary when the primary goal of colonoscopy is the detection of colonic neoplasms.