Scripps Clinic Physicians Are First in San Diego County to Use Ultrasound to Monitor Inflammatory Bowel Disease

80-year-old technology now being used in new, innovative way

Two female doctors view medical imaging, representing new strides being made by Scripps gastroenterologists for IBD care.

80-year-old technology now being used in new, innovative way

Ultrasound is a low-cost, 80-year-old technology that almost everyone has heard of, but only now is it making waves in the care of people with inflammatory bowel disease (IBD).

And a group of Scripps Clinic gastroenterologists has become the first in San Diego County to incorporate ultrasound into their care for patients with ulcerative colitis and Crohn’s disease — chronic IBD conditions that can be difficult to manage and treat properly.

“Ultrasound for IBD is an exciting innovation that is just starting to spread in this country among gastroenterologists,” said Rebecca Matro, MD, director of the Scripps Clinic Intestinal Ultrasound Program. “With an ultrasound machine readily available inside the patient exam room, we can quickly do a scan during a patient’s regular appointment to see how their disease is progressing and whether drug treatments or dietary changes are having their intended effect.” 

“Monitoring the activity of the disease is critical, and ultrasound is a cost-effective, point-of-care technology for doing that.”

Rebecca Matro, MD

In addition to Dr. Matro, IBD ultrasound exams are being offered by Gauree Konijeti, MD, at several Scripps Clinic outpatient locations across the county.

Previously, to get a look inside a patient, Dr. Matro and Dr. Konijeti would have had to schedule a colonoscopy, an invasive procedure that requires anesthesia and bowel preparation, or an MRI or CT scan that can take time to schedule and perform. However, for several reasons ranging from discomfort associated with preparation for procedures, delays in insurance authorization, costs and time off work, many patients do not follow through with those options. And that can be a problem for effectively managing IBD.

Intestinal ultrasound requires no bowel preparation, no fasting and no anesthesia. 

IBD affects 3.1 million in the U.S. 

Both Crohn’s disease and ulcerative colitis are chronic inflammatory conditions affecting the gastrointestinal tract. Symptoms can include diarrhea, rectal bleeding, abdominal pain, fatigue and weight loss, and range from mild to severe enough to be debilitating or even life-threatening.

About 3.1 million U.S. adults have IBD, according to the Centers for Disease Control and Prevention. While most IBD patients are diagnosed between the ages of 15 and 30, the chronic nature of the diseases means that people of all ages are affected. The causes of IBD remain a mystery, but they may include genes, the immune system, environmental factors and the gut microbiome. And while there is no cure for IBD, several drug and surgical therapies along with diet and lifestyle changes can help reduce gastrointestinal inflammation and resulting symptoms.

“When treating IBD, our main goals are healing the inside of the colon and small intestines, and reducing symptoms to the point that the patient is symptom free and able to live a normal life,” Dr. Matro said. “Monitoring the activity of the disease is critical, and ultrasound is a cost-effective, point-of-care technology for doing that.”

In other parts of the world where ultrasound has been widely used to monitor and manage IBD for many years, clinical studies have shown the technology to be as effective as an MRI. 

Ultrasound boosts patient engagement 

Research also has revealed another important benefit – patients who see and discuss their ultrasound images with their physicians in real time during a medical appointment have a better understanding of their disease and symptoms, and they have more confidence in their ability to make informed decisions about managing their condition.

“You can’t overstate the value of greater patient engagement for improving outcomes and long-term disease management,” Dr. Konijeti said.

Some might wonder why it has taken so long for a decades old technology to finally be embraced by gastroenterologists in the United States. Experts point to several factors at play here.

Since ultrasound techniques and interpretation are not taught as standard skills in medical schools and postgraduate training, most gastroenterologists are not able to perform the exam. However, new training programs at four U.S. medical centers and internationally are now available to physicians wishing to learn the technique.

Until recently, it wasn’t clear how physicians could bill for the procedure. But now, most insurance plans including Medicare cover IBD ultrasound as a component of regular exams for those patients.

Learn more about Scripps Health, a nonprofit integrated health system in San Diego, Calif.

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Keith Darce

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