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Non-Invasive Diagnosis of Inflammatory Bowel Disease Shows Promise

FRIDAY, July 16 (HealthDay News) -- Getting tested for inflammatory bowel disease through an endoscopy isn't a pleasant experience, but a new review of existing research suggests that a simple stool test may help doctors figure out who needs the more extensive screening.

Inflammatory bowel disease refers to a number of conditions -- including Crohn's disease and ulcerative colitis -- that can cause abdominal pain, diarrhea and bleeding (the disease is sometimes confused with irritable bowel syndrome, which is a different condition.)

Doctors look for signs of disease through endoscopies, which are procedures that require patients to allow a tube to be passed into their digestive system from the rectum.

In the new review, published online July 16 in BMJ, researchers sought to discover whether a test of proteins in the stool could help doctors discover whether an endoscopy is necessary.

The researchers, from University Medical Center Groningen in the Netherlands, analyzed six studies in a total of 670 adults and seven studies in a total of 371 children. They found that, overall, the protein screening reduced the number of endoscopies by two-thirds in adults and about one-third in children. But it also delayed diagnosis in 6 percent to 8 percent of the patients.

The stool test "is a useful screening tool for identifying patients who are most likely to need endoscopy for suspected inflammatory bowel disease," concluded Dr. Patrick van Rheenen, a pediatric gastroenterologist at University Medical Center Groningen, and colleagues in their report.

Dr. David A. Schwartz, a gastroenterologist who was not involved in the review, said the findings have the potential to change the way doctors screen patients. "If this strategy is borne out by future studies, and we get a rapid test that can be done in the office, this should be a nice addition to our diagnostic tools," said Schwartz, director of the Inflammatory Bowel Disease Center at Vanderbilt University.

In the big picture, Schwartz said, the findings are encouraging because they show medicine is moving closer to a way to check for inflammatory bowel disease without having to rely on an invasive test.

More information

The American Academy of Family Physicians has more about inflammatory bowel disease.

-- Randy Dotinga

SOURCES: BMJ, news release, July 16, 2010; David A. Schwartz, M.D., director, Inflammatory Bowel Disease Center at Vanderbilt University, Nashville, Tenn.

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