Magnifying colonoscopy used to predict disease relapse in patients with quiescent ulcerative colitis

Inflamm Bowel Dis. 2009 Nov;15(11):1663-9. doi: 10.1002/ibd.20949.


Background: Many patients with quiescent ulcerative colitis (UC) experience relapse. However, clinical and conventional colonoscopic signs are inadequate for predicting relapse. This study's aim was to investigate the effectiveness of magnifying colonoscopy in predicting relapse in patients with quiescent UC and to evaluate the association of the findings of magnifying colonoscopy with the histological findings.

Methods: Magnifying colonoscopy was performed in 57 patients with clinical and endoscopic inactive UC. Patients were divided into 3 groups according to the findings of magnifying colonoscopy as MR (magnify-regular), MI (magnify-irregular), and MD (magnify-defect). Their subsequent clinical course was compared to assess the clinical usefulness of magnifying observation in predicting relapse. We also compared histological findings according to Riley's criteria to each finding of magnifying colonoscopy.

Results: Within 12 months, 1 of 18 patients (6.7%), 10 of 22 patients (45.5%), and 12 of 17 patients (70.6%) with findings of magnifying colonoscopy of MR, MI, and MD, respectively, experienced relapse. The MR group had a significantly low relapse rate compared with the MD and MI groups (P = 0.016, P = 0.002). When histological findings were compared with the findings of magnifying colonoscopy, the mean score of each variable, such as acute inflammatory cell infiltrate, chronic inflammatory cell infiltrate, and crypt architectural irregularities was significantly lower in the MR group than in the MD and MI groups.

Conclusions: The findings of magnifying colonoscopy in patients with quiescent UC is useful for predicting relapse and is associated with histological grade of inflammation.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Colitis, Ulcerative / mortality*
  • Colitis, Ulcerative / pathology*
  • Colonoscopy / methods*
  • Colonoscopy / mortality*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Predictive Value of Tests
  • Prospective Studies
  • Recurrence
  • Severity of Illness Index*
  • Young Adult