This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Colonoscopic surveillance if Crohn's disease or ulcerative colitis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

People with inflammatory bowel disease

  • 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 developing colorectal cancer
    • 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
    • Follow-up
      • Offer colonoscopy with chromoscopy at 5 years

    • 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
    • Follow-up
      • Offer colonoscopy with chromoscopy at 3 years

    • 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
    • Follow-up
      • Offer colonoscopy with chromoscopy at 1 year

Notes:

  • If colonoscopy is incomplete offer a repeat colonoscopy with chromoscopy. Consider whether a more experienced colonoscopist is needed
  • If colonoscopy is not clinically appropriate, consider computed tomographic colonography (CTC). If CTC is not available or appropriate consider double contrast barium enema. Discuss the risks and benefits with the person and their family or carers if these techniques are being considered for ongoing surveillance

  • Findings at follow-up
    • Offer the next colonoscopy with chromoscopy based on the person's risk at their last complete colonoscopy
      • Low risk - offer at 5 years
      • Intermediate risk - offer at 3 years
      • High risk - offer at 1 year









 

Reference:


Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.