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Endoscopy 2008; 40(8): 656-663
DOI: 10.1055/s-2008-1077445
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Safety, feasibility, and tolerability of ileocolonoscopy in inflammatory bowel disease

G.  Terheggen1 , B.  Lanyi1 , S.  Schanz2 , R.  M.  Hoffmann3 , S.  K.  Böhm1 , L.  Leifeld1 , C.  Pohl4 , W.  Kruis1
  • 1Department of Internal Medicine, Evangelisches Krankenhaus Kalk, Köln, Germany
  • 2Department of Internal Medicine, Kreisklinikum Siegen, Germany
  • 3Department of Internal Medicine, Kreiskrankenhaus Gummersbach, Germany
  • 4Department of Internal Medicine, St. Elisabeth Krankenhaus, Köln, Germany
Further Information

Publication History

submitted 12 November 2007

accepted after revision 23 April 2008

Publication Date:
04 August 2008 (online)

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Commentaire de travail de G. Terheggen et al., pp. 656Endoscopy 2008; 40(08): 797-797
DOI: 10.1055/s-0032-1306861

Background and study aims: Ileocolonoscopy including biopsies is the first-line investigation in the diagnosis, management, and monitoring of inflammatory bowel disease (IBD). However, data on its safety, feasibility, and tolerability, especially in patients with extensive or severe inflammation, are rare. The aim of this study was to assess prospectively the risks of ileocolonoscopy in relation to various disease patterns and to compare possible burdens of the procedure in the endoscopist’s and the patient’s perception.

Patients and methods: We prospectively analyzed a total of 558 consecutive patients, 482 with a confirmed diagnosis of IBD and 76 with suspected IBD. Data were recorded regarding the indication for ileocolonoscopy, sedation, procedure time, completion rate, feasibility of the procedure, patient tolerance, and procedure-related and postprocedure complications. Endoscopic data included the region involved, the nature of the involvement, activity of the disease, and number of biopsies.

Results: In 558 endoscopic procedures performed by 14 gastroenterologists no procedure-related deaths occurred. Major complications, defined as bleeding (n = 1) or perforation (n = 3), occurred in 4/558 patients (0.7 %). Minor complications, which included intense flatulence, tachycardia, allergic reaction to a sedation drug, and autonomic symptoms such as nausea, vomiting, and intense perspiration, occurred in 22/558 patients (3.9 %). There was no relationship between the complication rate and the activity of the disease. Mean procedure time was 21.0 minutes and the completion rate, defined by intubation of the terminal ileum, was 94.6 %. We documented a high tolerability independent of the severity of the disease.

Conclusions: Ileocolonoscopy is a safe and feasible procedure in patients with IBD and is well tolerated by patients when carried out by well-trained endoscopists.

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G. Terheggen, MD 

Department of Internal Medicine
Evangelisches Krankenhaus Kalk

Buchforststraße 2
51103 Köln
Germany

Email: gterheggen@web.de