Monitoring disease activity and progression in Crohn's disease. A Swiss perspective on the IBD ahead 'optimised monitoring' recommendations.

Sauter, Bernhard; Beglinger, Christoph; Girardin, Marc; Macpherson, Andrew; Michetti, Pierre; Schoepfer, Alain; Seibold, Frank Werner; Vavricka, Stephan R; Rogler, Gerhard (2014). Monitoring disease activity and progression in Crohn's disease. A Swiss perspective on the IBD ahead 'optimised monitoring' recommendations. Digestion, 89(4), pp. 299-309. Karger 10.1159/000360283

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BACKGROUND AND AIMS The structured IBD Ahead 'Optimised Monitoring' programme was designed to obtain the opinion, insight and advice of gastroenterologists on optimising the monitoring of Crohn's disease activity in four settings: (1) assessment at diagnosis, (2) monitoring in symptomatic patients, (3) monitoring in asymptomatic patients, and (4) the postoperative follow-up. For each of these settings, four monitoring methods were discussed: (a) symptom assessment, (b) endoscopy, (c) laboratory markers, and (d) imaging. Based on literature search and expert opinion compiled during an international consensus meeting, recommendations were given to answer the question 'which diagnostic method, when, and how often'. The International IBD Ahead Expert Panel advised to tailor this guidance to the healthcare system and the special prerequisites of each country. The IBD Ahead Swiss National Steering Committee proposes best-practice recommendations adapted for Switzerland. METHODS The IBD Ahead Steering Committee identified key questions and provided the Swiss Expert Panel with a structured literature research. The expert panel agreed on a set of statements. During an international expert meeting the consolidated outcome of the national meetings was merged into final statements agreed by the participating International and National Steering Committee members - the IBD Ahead 'Optimized Monitoring' Consensus. RESULTS A systematic assessment of symptoms, endoscopy findings, and laboratory markers with special emphasis on faecal calprotectin is deemed necessary even in symptom-free patients. The choice of recommended imaging methods is adapted to the specific situation in Switzerland and highlights the importance of ultrasonography and magnetic resonance imaging besides endoscopy. CONCLUSION The recommendations stress the importance of monitoring disease activity on a regular basis and by objective parameters, such as faecal calprotectin and endoscopy with detailed documentation of findings. Physicians should not rely on symptoms only and adapt the monitoring schedule and choice of options to individual situations.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Gastroenterology

UniBE Contributor:

Macpherson, Andrew and Seibold, Frank Werner

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0012-2823

Publisher:

Karger

Language:

English

Submitter:

Lilian Karin Smith-Wirth

Date Deposited:

22 Apr 2015 09:16

Last Modified:

08 Sep 2017 16:03

Publisher DOI:

10.1159/000360283

PubMed ID:

25074029

Uncontrolled Keywords:

Chronic inflammatory bowel disease; Crohn’s disease; Disease monitoring; Recommendations; Best-practice guidelines; Endoscopy; Multidetector computed tomography; Calprotectin; Small intestine contrast ultrasonography; Contrast-enhanced ultrasound

BORIS DOI:

10.7892/boris.66987

URI:

https://boris.unibe.ch/id/eprint/66987

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