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Endoscopic evaluation of bezoars and foreign bodies in inflammatory bowel diseases

Abbreviations CD Crohn’s disease IBD inflammatory bowel disease IPAA ileal pouch–anal anastomosis UC ulcerative colitis Introduction Bezoars in the gastrointestinal tract are accumulated indigestible foreign materials, which can produce concretions. According to their compositions, Bezoars have been classified into following types: (1) phytobezoars (vegetable or fruit fibers), (2) lactobezoars (milk or dairy proteins), (3) trichobezoars (hairs), (4) lithobezoars (calcified, stone-like materials), and (5) pharmacobezoars (medications) .…

Inflammatory bowel disease–associated bleeding

Abbreviations CD Crohn’s disease GI gastrointestinal IBD inflammatory bowel disease UC ulcerative colitis Introduction Bloody bowel movement is a common presentation of active ulcerative colitis (UC). In contrast, brisk bleeding in Crohn’s disease (CD) is uncommon. Rather, patients with CD often present with iron-deficiency anemia or anemia of chronic disease. The patterns of gastrointestinal (GI) hemorrhage in inflammatory bowel disease (IBD) ranges from obscure bleeding to…

Transmural endoscopic imaging in inflammatory bowel disease

Abbreviations CD Crohn’s disease IBD inflammatory bowel disease EUA examination under anesthesia EUS endoscopic ultrasound MRI magnetic resonance imaging OCT optical coherence tomography Introduction Endoluminal imaging plays a crucial role in the primary diagnosis and management of patients with inflammatory bowel disease (IBD). Advances in the field of ultrasonography and fiber optics have enhanced the ability to assess the gastrointestinal tract transmurally. This chapter provides an…

Histology correlation with common endoscopic abnormalities

Abbreviations AFB acid-fast bacillus AIC acute infectious colitis AIE autoimmune enteropathy CD Crohn’s disease DALM dysplasia-associated lesion or mass EMR endoscopic mucosal resection GI gastrointestinal GVHD graft-versus-host disease IBD inflammatory bowel disease ITB intestinal tuberculosis NSAIDs Nonsteroidal antiinflammatory drugs SRUS solitary rectal ulcer syndrome TNF tumor necrosis factor UC ulcerative colitis Introduction Reaching an accurate diagnosis of inflammatory bowel disease (IBD) requires the synthesis of clinical,…

Inflammatory bowel disease–like conditions: gastrointestinal lymphoma and other neoplasms

Abbreviations CCS Cronkhite–Canada syndrome CD Crohn’s disease DLBL diffuse large B-cell lymphoma EATL enteropathy-associated T-cell lymphoma FAP familial adenomatous polyposis H & E hematoxylin-Eosin HNPCC hereditary nonpolyposis colorectal cancer IBD inflammatory bowel disease LPD lymphoproliferative disorders MALT mucosa-associated lymphoid tissue MCL mantle cell lymphoma NK natural killer NET neuroendocrine tumor NHL non-Hodgkin’s lymphoma PGIL primary gastrointestinal lymphoma PJS Peutz–Jeghers syndrome UC ulcerative colitis Introduction The incidence…

Inflammatory bowel disease–like conditions: miscellaneous

Abbreviations CD Crohn’s disease CSC cat scratch colon EGID eosinophilic gastrointestinal disorders CMUSE cryptogenic multifocal ulcerous stenosing enteritis IBD inflammatory bowel disease UC ulcerative colitis Introduction A long list of conditions can present inflammation or ulcers or strictures in the gastrointestinal (GI) tract. These conditions include eosinophilic GI disorders (EGID), cryptogenic multifocal ulcerous stenosing enteritis (CMUSE), sclerosing mesenteritis, diverticular colitis, and rectal prolapse. They mimic inflammatory…

Inflammatory bowel disease–like conditions: monogenic gastrointestinal disorders

Abbreviations CD Crohn’s disease GI gastrointestinal IBD inflammatory bowel disease IL10RA interleukin 10 receptor-α IPEX immune dysregulation, polyendocrinopathy, enteropathy, X-linked LRBA LPS-responsive beige-like anchor protein VEOIBD very early–onset inflammatory bowel disease Introduction Very early–onset inflammatory bowel disease (IBD) (VEOIBD) refers to patients who have onset of disease before 6 years of age . The majority of patients in this group have monogenic defects. To date, there…

Inflammatory bowel disease–like conditions: immune deficiencies

Abbreviations CD Crohn’s disease CVID common variable immune deficiency GI gastrointestinal IBD inflammatory bowel disease Ig immunoglobulin IVIG intravenous immunoglobulin SIgAD selective IgA deficiency UC ulcerative colitis Introduction Primary or secondary immune defects can occur in both children and adults. Primary immune defects are mainly seen in pediatric patients. In contrast, immune defects in adults often result from secondary causes. Secondary immune disorders can be caused…

Inflammatory bowel disease–like conditions: medication-induced enteropathy

Abbreviations 5-FU 5-fluorouracil ACEIs angiotensin-converting enzyme inhibitors CD Crohn’s disease CMV cytomegalovirus COX cyclooxygenase CTLA-4 anticytotoxic T-lymphocyte-association protein-4 GI gastrointestinal IBD inflammatory bowel disease ICIs immune checkpoint inhibitors MMF mycophenolate mofetil NSAIDs nonsteroidal antiinflammatory drugs OAE olmesartan-associated enteropathy PD-1 programmed cell death protein-1 PERT pancreatic enzyme replacement therapy SPS sodium polystyrene sulfonate Introduction Many conditions may share the clinical and endoscopic features of inflammatory bowel disease…

Inflammatory bowel disease–like conditions: ischemic bowel diseases and vasculitides

Abbreviations ANCA antineutrophil cytoplasmic antibody BD Behçet disease CD Crohn’s disease CT computed tomography EGPA eosinophilic granulomatosis with polyangiitis IBD inflammatory bowel disease GI gastrointestinal Ig immunoglobulin PAN polyarteritis nodosa SLE systemic lupus erythematosus UC ulcerative colitis Introduction Diagnosis and differential diagnosis of inflammatory bowel disease (IBD) are important for the management and prognosis. Among mimics of IBD a group of diseases with underlying ischemia, vasculitis,…

Inflammatory bowel disease–like conditions after organ transplantation

Abbreviations CD Crohn’s disease CMV cytomegalovirus DAMP disease-associated molecular pattern EBV Epstein–Barr virus GI gastrointestinal GVHD graft-versus-host disease HSCT hematopoietic stem cell transplantation IBD inflammatory bowel disease MMF mycophenolate mofetil OLT orthotopic liver transplantation OT organ transplantation PSC primary sclerosing cholangitis SOT solid organ transplantation UC ulcerative colitis Introduction The reported prevalence of diarrhea is up to 72% after solid-organ transplantation (SOT) or hematopoietic stem cell…

Inflammatory bowel disease–like conditions: other immune-mediated gastrointestinal disorders

Abbreviations AID autoinflammatory disease AIE autoimmune enteropathy ANA antinuclear antigen CTLA-4 cytotoxic T-cell lymphocyte-4 CC collagenous colitis CeD celiac disease CD Crohn’s disease FMF familial Mediterranean fever GI gastrointestinal IBD inflammatory bowel disease ICPi immune checkpoint inhibitor IMD immune-mediated disorder LC lymphocytic colitis MC microscopic colitis NAID NOD2-associated autoinflammatory diseases NSAID nonsteroidal antiinflammatory drug PD-1 programmed cell death 1 protein PSC primary sclerosing cholangitis RA rheumatoid…

Inflammatory bowel disease–like conditions: infectious

Abbreviations AIDS acquired immune deficiency syndrome CD Crohn’s disease CMV Cytomegalovirus GI gastrointestinal HIV human immunodeficiency virus IBD inflammatory bowel disease ICV ileocecal valve UC ulcerative colitis Introduction Infectious bowel diseases are more common in developing countries than industrialized countries. On the other hand, the incidence and prevalence of inflammatory bowel disease (IBD) in the former are increasing . Superimposed bacterial, viral, fungal, or parasitic infection…

Inflammatory bowel disease–associated digestive disorders

Abbreviations AIH autoimmune hepatitis AIP autoimmune pancreatitis CD Crohn’s disease EoE eosinophilic esophagitis GAVE gastric antral vascular ectasia GERD gastroesophageal reflux disorder GI gastrointestinal IBD inflammatory bowel disease IBS irritable bowel syndrome ICV ileocecal valve IPAA ileal pouch–anal anastomosis NSAIDs nonsteroidal anti-inflammatory drugs PSC primary sclerosing cholangitis UC ulcerative colitis Introduction Inflammatory bowel disease (IBD), that is, Crohn’s disease (CD) and ulcerative colitis (UC), can affect…

Superimposed infections in inflammatory bowel diseases

Abbreviations CD Crohn’s disease CDI Clostridioides difficile infection CJI Campylobacter jejuni infection CMV cytomegalovirus EBV Epstein–Barr virus H & E hematoxylin and eosin HPV human papillomavirus HSV herpes simplex virus GI gastrointestinal IBD inflammatory bowel disease ICV ileocecal valve ITB intestinal tuberculosis TB tuberculosis TNF tumor necrosis factor UC ulcerative colitis Introduction Crohn’s disease (CD) and ulcerative colitis (UC) are the two most common forms of…

Inflammatory bowel disease–like conditions: radiation injury of the gut

Abbreviations AVM arteriovenous malformation GI gastrointestinal IBD inflammatory bowel disease UC ulcerative colitis Introduction Gastrointestinal (GI) tract is vulnerable to radiation injury, consisting acute and chronic forms. The acute injury exerts cytotoxic effect on the fast dividing intestinal epithelium, particularly intestinal stem cells, with subsequent changes in cell death. Downregulation of Bcl-2 plays a central role. The disruption of intestinal epithelial barrier may lead to bacterial…

Molecular imaging in inflammatory bowel disease

Abbreviations CAC colitis-associated cancer CD Crohn’s disease CLE confocal laser endomicroscopy CT computed tomography FITC fluorescein isothiocyanate IBD inflammatory bowel disease SSA sessile serrated adenoma SPECT single-photon emission computed tomography TNF tumor necrosis factor VDZ vedolizumab Introduction Molecular imaging is based on the principle of utilizing fluorescently labeled probes with high specificity toward defined molecular targets and their subsequent detection and visualization with endoscopic devices (…

Confocal endomicroscopy and other image-enhanced endoscopy in inflammatory bowel disease

Abbreviations CAN colitis-associated neoplasia CD Crohn’s disease CLE confocal laser endomicroscopy DCE dye chromoendoscopy eCLE endoscopy-based confocal laser endomicroscopy GI gastrointestinal HD high-definition IBD inflammatory bowel disease IEE image-enhanced endoscopy ME magnification endoscopy MH mucosal healing NBI narrow-band imaging OCT optical coherence tomographyp CLE confocal laser endomicroscopy PSC primary sclerosing cholangitisTNF tumor necrosis factor UC ulcerative colitis WLE white-light endoscopy Introduction Advances in imaging technology have…

Chromoendoscopy in inflammatory bowel disease

Abbreviations AFI autofluorescence imaging BLI blue-light imaging CAN colitis-associated neoplasia CD Crohn’s disease CDEIS Crohn's Disease Endoscopic Index of Severity CI confidence interval CRC colorectal cancer DCE dye chromoendoscopy CLE confocal laser endomicroscopy FACILE the Frankfurt Advanced Chromoendoscopic IBD LEsions FICE flexible spectral imaging color enhancement HD high definition GI gastrointestinal IBD inflammatory bowel disease IEE image-enhanced endoscopy IPAA ileal pouch-anal anastomosis ME magnification endoscopy MES…

Enteroscopy in inflammatory bowel disease and inflammatory bowel disease–like conditions

Abbreviations CD Crohn’s disease CMUSE cryptogenic multifocal ulcerous stenosing enteritis BD Behcet’s disease IBD inflammatory bowel disease ITB intestinal tuberculosis MALT mucosa-associated lymphoid tissue NSAID nonsteroidal antiinflammatory drug UC ulcerative colitis Introduction The small bowel, as the midsection of the gastrointestinal tract between the stomach and colon, is 5–7 m long and divided into the duodenum, jejunum, and ileum. The enteroscopy, which can not only make…