Original articleClinical endoscopyIncreased epithelial gaps in the small intestines of patients with inflammatory bowel disease: density matters
Section snippets
Patients
This is a prospective, controlled, cohort study registered at ClinicalTrial.Gov (NCT00988273). The study protocol was reviewed and approved by the Human Ethics Research Review Board at the University of Alberta. The study group consisted of patients either previously diagnosed or suspected to have a diagnosis of IBD. The control group consisted of patients undergoing colonoscopy for non-IBD-related indications such as colon cancer screening, symptoms of irritable bowel syndrome, and rectal
Results
The baseline patient characteristics of the IBD and control groups are shown in Table 1. Patients with IBD were significantly younger than controls, with a mean (± SD) age of 40.3 ± 14.1 years versus 53.0 ± 14.7 years (P = .001). Analysis was performed on 27 of 28 patients with IBD, because pCLE could not be carried out in one patient with Crohn's disease because of the inability to intubate the terminal ileum. We imaged only endoscopically normal-appearing mucosa by using pCLE. A
Discussion
In this study, we showed that patients with IBD had significantly higher epithelial gap densities in the terminal ileum compared with controls who did not have IBD. The findings of our study are consistent with our hypothesis that patients with IBD have increased epithelial cell shedding in the small intestine, which can be measured by gap density by using pCLE. In our secondary analysis, we found that patients with ulcerative pancolitis tended to have gap densities lower than those with
Acknowledgment
We would like to thank Dr Jon Meddings and Dr Jerold Turner for their helpful suggestions with the design of our study.
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DISCLOSURE: This work was supported in part by a grant to J. Liu from the Canadian Institutes of Health Research/Canadian Association of Gastroenterology and a grant to R. Fedorak from the Canada Foundation for Innovation. No other financial relationships relevant to this publication were disclosed.
If you would like to chat with an author of this article, you may contact Dr Liu at [email protected].