Endoscopy and colonoscopy are often the first-line procedure for diagnosing Ulcerative Colitis (UC), a prevalent form of IBD which primarily affects mucosal and submucosal layers of the colon and rectum. An endoscope allows the physician to assess mucosal inflammation, disease activity, and response to treatment, however, endoscopy has some limitations that have caused radiologists to ask, is MR enterography being underutilized for diagnosing UC?
In their recent publication, "MR Enterography in Ulcerative Colitis: Beyond Endoscopy," Radmard et al shares how MRE can be successful where endoscopy falls short. “One of the primary limitations of endoscopy is its inability to visualize beyond the mucosal layer. MRE, on the other hand, offers a comprehensive view of the entire gastrointestinal tract, providing valuable information about mural and extramural abnormalities. This includes assessing inaccessible parts of the colonic lumen, which is particularly beneficial in cases where endoscopy may be contraindicated due to the risk of colonic perforation.”
Why MRE and not solely endoscopy?
According to the authors, there are a few reasons one might want to use MRE and not rely solely upon endoscopy.
MR enterography can:
- Image features of chronicity in patients presenting with undiagnosed UC
- Highlight deep mural ulcers, imaging signs that suggest superimposed cytomegalovirus colitis, particularly when the right colon is more severely involved
- Provide crucial information on obstructive polypoid lesion size, the inaccessible upstream colonic lumen, potential extramural involvement, and the status of the underlying disease
“MRE has an important role in the assessment of UC and has been underused compared with its use for CD (Chrohn's Disease). Although UC is characterized as an inflammatory disease of the colorectal mucosa, various related abnormalities might be underdiagnosed with endoscopic examination. The radiologist can play a pivotal role in the management of UC with MRE by exploring what is beyond endoscopy.”
Why not MRE? Patient satisfaction can be a hurdle
One reason imaging facilities provide for not performing enterography exams often has to do with the patients oral prep.
Distention of the small bowel is the end goal and to that end patients typically drink between 1000 – 15000 ml of a neutral agent. This volume can be a problem for already sick patient, and is compounded by the poor taste and the viscous texture of one commonly used neutral agent.
Breeza flavored beverage for neutral abdominal/pelvic imaging is a non-carbonated, sugar-free, gluten-free beverage with a light, refreshing lemon-lime flavor which has a viscosity of 10.5cP (slightly more viscous than water) and provides a better "mouth feel" and is more palatable for patients.
A more palatable solution helps make enterography exams a breeze
In separate studies by Mayo Clinic and Cincinnati Children’s Hospital, patients rated Breeza flavored beverage as the most palatable oral prep and were more likely to repeat the exam if it were available.
Patients with IBD (such as ulcerative colitis and Crohn’s) face a lifetime of regular imaging and if a palatable oral prep is a part of their health journey, they will be more likely to return for follow up on treatment and progress.
To learn more about Breeza flavored beverage for neutral abdominal/pelvic imaging and how it can increase patient satisfaction, contact your Business Development Manager at 1-800-233-5539 or email info@beekley.com.
Jonathan McCullough
Product Manager
