No Role for Routine Upper Endoscopy in Adults With Ulcerative Colitis

Does upper endoscopy affect the diagnosis or management of adults with colitis? No, say investigators from Cedars-Sinai Medical Center in Los Angeles, although the procedure is routinely performed in children with inflammatory bowel disease (IBD) of the colon.¹

In this case-control study, 50 patients with ulcerative colitis (cases) and 50 patients with Crohn disease (controls) were assessed. Symptoms of heartburn/reflux and epigastric pain were similar in each group; nausea and/or vomiting was less common in those with ulcerative colitis than in those with Crohn disease (8% vs 26%; P = .016).

Endoscopy findings in the patients with ulcerative colitis were similar to those in patients with Crohn disease, including non–Helicobacter pylori gastritis. Because upper endoscopy among patients with ulcerative colitis does not often lead to changes in management and only rarely results in a change in diagnosis, its routine use does not seem to be warranted in the absence of upper GI symptoms. 

References:

REFERENCE:
1. Kaneshiro M, Shih D, McGovern D, et al. Does upper endoscopy impact the diagnosis or management of adults with colitis? Paper presented at: 2010 Advances in Inflammatory Bowel Diseases Conference; December 9-12, 2010; Hollywood, Florida.