To Track Colitis, Listen to the Patient

Review of symptoms just as accurate as endoscopy, study found.

When it comes to monitoring the progression of painful ulcerative colitis, doctors need only listen to patients, a new study suggests.

Patient-reported symptoms of ulcerative colitis - characterized by fatigue, abdominal pain and bloody diarrhea - provide an effective alternative to costly, invasive endoscopy as a way of tracking disease progression, report researchers at the University of Michigan Health System, Ann Arbor.

Besides sparing patients the discomfort of having regular colonoscopies, the finding may also save researchers the cost of using the high-tech procedure during clinical trials.

The study included 66 ulcerative colitis patients with varying disease activity. For five months, researchers tracked disease progression using either the results of a detailed patient questionnaire plus a blood sample, or regularly scheduled endoscopy.

They found that prediction of disease activity through the questionnaire/blood sample was nearly as good (only a 3 percent difference) as that gleaned from endoscopy.

The findings appear in the February issue of the American Journal of Gastroenterology.

"This study suggests that endoscopy does not provide physicians with enough new information about the activity of the patient's disease to make it necessary for patients to have to undergo the discomfort of an endoscopy," study lead author Dr. Peter D. R. Higgins, lecturer in the division of gastroenterology and hepatology, department of internal medicine, said in a prepared statement.

In the same statement, his UMHS co-author Dr. Ellen Zimmerman added, "While endoscopy is still necessary to diagnose ulcerative colitis and to evaluate a patient or early signs of cancer, patients may be more willing to participate in clinical trials of new treatments if there are not so many colonoscopies involved."