Korean J Intern Med.  2017 Sep;32(5):916-922. 10.3904/kjim.2015.313.

Ileocolonoscopic findings in patients with ankylosing spondylitis: a single center retrospective study

Affiliations
  • 1Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. bestmd2000@amc.seoul.kr
  • 2Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

BACKGROUND/AIMS
In some Western countries, up to 50% of patients with ankylosing spondylitis (AS) have subclinical gut inflammation. This study was conducted to evaluate the prevalence and severity of gut inflammation and to determine clinical factors associated with colonic inflammation in Korean AS patients who performed ileocolonoscopy without evidence of established inflammatory bowel diseases before.
METHODS
One hundred and eight AS patients who underwent ileocolonoscopy were included in this study. Patients were divided into two groups based on gross ileocolonoscopic findings; patients with inflammatory lesions, and patients without inflammatory lesions.
RESULTS
Inflammatory lesions in ileocolonoscopic findings were found in 40 patients. The Ankylosing Spondylitis Disease Activity Score C-reactive protein was higher in the group with inflammatory lesions and gut lesions were found often in the terminal ileum. The risk of inflammatory lesions was higher for AS patients whose symptoms required ileocolonoscopy than for AS patients who underwent routine ileocolonoscopy screening (odds ratio, 3.96). However, abnormal lesions were detected also in 17.6% of the patients who underwent ileocolonoscopy for routine screening and most of them were erosion and ulcer. Among patients with inflammatory lesions (n = 40), 23 showed subclinical gut inflammation associated with AS and 17 were diagnosed finally as Crohn's disease (n = 12), intestinal tuberculosis (n = 4), and ulcerative colitis (n = 1).
CONCLUSIONS
Our findings suggest that ileocolonoscopy might be recommended regularly in AS patients even without gastrointestinal symptoms, especially in the patients with high AS activity.

Keyword

Spondylitis, ankylosing; Colonoscopy; Inflammatory bowel diseases; Gastrointestinal diseases

MeSH Terms

C-Reactive Protein
Colitis, Ulcerative
Colon
Colonoscopy
Crohn Disease
Gastrointestinal Diseases
Humans
Ileum
Inflammation
Inflammatory Bowel Diseases
Mass Screening
Prevalence
Retrospective Studies*
Spondylitis, Ankylosing*
Tuberculosis
Ulcer
C-Reactive Protein
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