Rectal and Rectosigmoid Endoscopy to Assess Endoscopic and Histological Remission in Ulcerative Colitis: A...

Area of Science:

• Gastroenterology
• Inflammatory Bowel Disease Research
• Clinical Endoscopy

Background:

• Ulcerative colitis (UC) treatment increasingly targets endoscopic and histological remission.
• The accuracy of left colon and rectal findings for detecting pancolonic remission is not well-established.

Purpose of the Study:

• To compare the diagnostic accuracy of rectosigmoidoscopy (RS) and rectoscopy for detecting endoscopic and histological healing in the entire colon of UC patients.

Main Methods:

• Prospective inclusion of UC patients undergoing colonoscopy.
• Endoscopic healing defined as Mayo endoscopic score (MES) = 0; histological healing as Nancy index ≤ 1.
• Agreement assessed using Cohen's kappa coefficient between colonoscopy, RS, and rectoscopy.

Main Results:

• High agreement (kappa ≈ 0.83–0.95) between colonoscopy and RS/rectoscopy for both endoscopic and histological healing.
• Rectoscopy showed almost perfect agreement (kappa = 0.83 for endoscopic, 0.80 for histological healing) with colonoscopy.

Conclusions:

• Rectal endoscopic and histological findings accurately predict pancolonic remission in UC patients.
• Rectal examination can serve as a viable alternative to RS for monitoring UC patients.