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Colonoscopy surveillance guidelines for people with Inflammatory Bowel Disease

by Etienne Moore last modified 2012-04-28 21:18

Click here for Mr Moore's clinic advice for colonoscopy follow up of Inflammatory Bowel Disease patients

Offer colonoscopic surveillance to people whose symptoms started 10 years ago and who have ulcerative colitis (but not proctitis alone) or Crohn's colitis involving more than one segment of colon

Offer a baseline colonoscopy with chromoscopy and targeted biopsy of any abnormal areas to determine the risk of colorectal cancer :

High Risk

Extensive ulcerative or Crohn's colitis with moderate or severe active inflammation (confirmed endoscopically or histologically)

or primary sclerosing cholangitis (including after liver transplant)

or colonic stricture in the past 5 years or any grade of dysplasia in the past 5 years

or family history of colorectal cancer in a first-degree relative aged under 50

Offer colonoscopy with chromoscopy in 1 year

If colonoscopy is incomplete offer a repeat colonoscopy with chromoscopy and consider whether a more experienced colonoscopist is required.

Offer the next colonoscopy based on the patient's risk at their last complete colonoscopy (Low risk 5 years, Intermediate risk 3 years, High risk 1 year).

Intermediate Risk

Extensive ulcerative or Crohn's colitis with mild active inflammation (confirmed endoscopically or histologically)

or post-inflammatory polyps

or family history of colorectal cancer in a first-degree relative aged 50 or over

Offer colonoscopy with chromoscopy in 3 years

If colonoscopy is incomplete offer a repeat colonoscopy with chromoscopy and consider whether a more experienced colonoscopist is required.

Offer the next colonoscopy based on the patient's risk at their last complete colonoscopy (Low risk 5 years, Intermediate risk 3 years, High risk 1 year).

Low Risk

Left-sided ulcerative colitis (but not proctitis alone) or Crohn's colitis of a similar extent

or extensive but quiescent ulcerative colitis

or extensive but quiescent Crohn's colitis

Offer colonoscopy with chromoscopy in 5 years

If colonoscopy is incomplete offer a repeat colonoscopy with chromoscopy and consider whether a more experienced colonoscopist is required.

Offer the next colonoscopy based on the patient's risk at their last complete colonoscopy (Low risk 5 years, Intermediate risk 3 years, High risk 1 year).

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