Crohn’s Disease - ENDOSCOPY

Posted by Alex

Patients presenting with colitic symptoms of rectal bleeding, cramping, tenesmus, mucopus, or watery diarrhea in conjunction with fecal leukocytes warrant a colonic examination. A proctoscopic examination or flexible sigmoidoscopy reveals the presence and pattern of distal colonic inflammation. In the absence of perianal disease, diffuse, continuous mucosal changes with a distinct upper boundary to adjacent normal-appearing mucosa are typical of ulcerative proctitis or proctosigmoiditis. Focal inflammation with aphthoid ulcers, linear or stellate ulcers with normal intervening mucosa, or inflammatory changes beginning above the rectum (rectal sparing) in previously untreated patients suggest CD. If the patient is not acutely ill, colonoscopy demonstrates more proximal colonic changes and allows examination and intubation of the ileocecal valve to evaluate terminal ileal findings. Patients with upper abdominal symptoms can be diagnosed with upper gastrointestinal endoscopy when typical mucosal changes of CD involve this area. Findings can be correlated with mucosal biopsy studies and radiographic evaluation of the small and large intestine.