Early Flexible Sigmoidoscopy Improves Clinical Outcomes in Acute Severe Ulcerative Colitis

Area of Science:

• Gastroenterology
• Clinical Medicine
• Inflammatory Bowel Disease

Background:

• Flexible sigmoidoscopy is recommended for acute severe ulcerative colitis (ASUC) hospitalizations.
• The impact of the timing of sigmoidoscopy on clinical outcomes in ASUC remains unclear.

Purpose of the Study:

• To assess the effect of early versus delayed sigmoidoscopy on clinical outcomes in patients with ASUC.

Main Methods:

• Retrospective single-center study of 112 patients hospitalized with ASUC.
• Early sigmoidoscopy defined as within 72 hours of admission; delayed sigmoidoscopy as >72 hours.
• Primary outcomes included IV corticosteroid use, hospital stay duration, and colectomy rates.

Main Results:

• Early sigmoidoscopy (n=87) was associated with significantly fewer IV corticosteroid days (4.5 vs 9.2) and shorter hospital stays (6.4 vs 19.3 days) compared to delayed sigmoidoscopy (n=25).
• Time to infliximab rescue was shorter with early sigmoidoscopy (3.5 vs 6.4 days).
• While colectomy rates were 17% (early) vs 28% (delayed), longer time to sigmoidoscopy increased colectomy risk by 16% (HR=1.16).

Conclusions:

• Early sigmoidoscopy in ASUC patients is associated with improved clinical outcomes.
• Findings suggest benefits of timely endoscopic evaluation in ASUC management.
• Larger prospective studies are warranted to confirm these results.