The Role of Bedside Intestinal Ultrasound in IBD Management

Patients with inflammatory bowel disease (IBD) need accessible, timely, and noninvasive monitoring strategies. Bedside intraabdominal ultrasound (IUS) is a beneficial tool for diagnosing and monitoring patients with IBD, including both Crohn's disease and ulcerative colitis.^1,2 Integrating IUS can have a significant impact on decision-making and endoscopy use in a standardized care pathway for these patients, given that the benefits outweigh the risks and costs of other imaging modalities.

IUS is radiation free, and provides accurate point-of-care detection of bowel wall thickening and inflammation in individuals with IBD.³ This imaging is effective for monitoring treatment response and guiding early interventions and is suitable for special populations (e.g., pediatrics and patients who are pregnant or obese).^1,2 IUS allows for medication adjustments without requiring urgent endoscopies or special preparations.¹ The small and large intestine can be visually monitored for IBD activity with IUS, with occasional exception regarding the rectum because of its deep location; however, a transperineal or transrectal ultrasound approach may be needed to view the rectum and perianal areas.^2,3

Further, in 2024, AGA reviewed and provided guidance on the use of IUS in IBD care,¹ underscoring its growing importance and utility. IUS provides a noninvasive, cost-effective, and accurate method for IBD evaluation and monitoring.