Author/Editor		Dajčman, Davorin
Title		Vloga kolonoskopske preiskave pri kronični vnetni črevesni bolezni (KVČB)
Translated title		The role of a colonoscopy in inflammatory bowel disease (IBD)
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 77, št. 9
Publication year		2008
Volume		str. 623-7
Language		slo
Abstract		Background. Gastrointestinal endoscopy provides details of the surface of the gastrointestinal tract, which has made it possible to examine it. Despite significant advances in our understanding and treatment of inflammatory bowel disease, the role of gastrointestinal endoscopy in diagnosis, surveillance and therapy of inflammatory bowel disease patients is still controversal. Of course, endoscopy plays a key role in the management of inflammatory bowel disease. Indication for endoscopy in patients with inflammatory bowel disease are diverse and commonly prompted by acute events on the need for colorectal cancer screening. However dyscomfort, potential risks and costs associated to endoscopic examination should contribute to the narrowing of indication to those cases in which the results of endoscopy is essential to determine a variation in the management strategy. In this article author provides a critical review of the value and yield of an endoscopy in various clinical scenarios where an endoscopy is commonly entertained in patients with inflammatory bowel disease. Colonoscopy has a prognostic role during severe flare of inflammatory bowel disease, both in ulcerative colitis and Chron's disease; moreover in Crohn's disease the evaluation of recurrent lesions aftercurative treatment has a strong prognostic role. Conclusions. The author emphasizes that an endoscopy should not routinely be used to evaluate disease activity in patients who are doing well and are in remission. The article provides 10 valuable tips about how to integrate an endoscopy into the management of patients with inflammatory bowel disease and reviews the role endoscopy plays in patient with bloody diarrhea, distinguishing Crohn's disease from ulcerative colitis at an endoscopy, in patient with chronic nonbloody diarrhea and cancer surveillance in patients with inflammatory bowel disease.
Summary		Izhodišča. Gastrointestinalna endoskopija omogoča pregled površine sluznice prebavne cevi, kar omogoča, da z njo odkrivamo spremembe prebavil. Kljub našemu modernemu razumevanju kronične vnetne črevesne bolezni vloga gastrointestinalne endoskopije pri odkrivanju, zdravljenju in sledenju bolnikov še zmeraj ni natančno določena. Seveda ima ključno vlogo pri obravnavi bolnikov, saj so indikacije za preiskavo pri teh bolnikih zelo široke, še posebej priporočene pa pri bolnikih, pri katerih pomislimo na raka debelega črevesa. Zaradi neprijetnosti, stroškov in dejavnikov tveganja na drugi strani pa morajo endoskopske preiskave biti odrejene le tistim bolnikom, pri katerih lahko na podlagi njihovih izsledkov pomembno vplivamo na spremembo zdravljenja. V pričujočem članku avtor razpravlja o pomenu in koristi gastrointestinalne endoskopije pri različnih kliničnih stanjih kronične vnetne črevesne bolezni. Kolonoskopija ima zelo veliko napovedno vrednost pri obeh oblikah kronične vnetne črevesne bolezni, tako pri ulceroznem kolitisu kot pri Crohnovi bolezni. Še posebej pomembna je endoskopska ocena sluzničnih okvar po zaključku ciljnega zdravljenja Crohnove bolezni. Zaključki. Avtor poudari, da redne endoskopske preiskave za oceno aktivnosti bolezni niso potrebne pri bolnikih, ki nimajo težav oziroma je bolezen v remisiji. V članku je prikazanih tudi 10 uporabnih nasvetov, kako vključiti endoskopijo v obravnavo bolnika s kronično vnetno črevesno boleznijo, in kakšna je njena vloga pri bolnikih s krvavimi driskami, za endoskopsko razlikovanje med ulceroznim kolitisom in Crohnovo boleznijo, nekrvavečimi kroničnimi driskami ter kakšna je vloga endoskopije pri zgodnjem odkrivanju raka debelega črevesa ob prisotnosti kronične vnetne črevesne bolezni.
Descriptors		INFLAMMATORY BOWEL DISEASES COLITIS, ULCERATIVE CROHN DISEASE ENDOSCOPY, GASTROINTESTINAL COLONOSCOPY