Risk for IBD Remains High After Endoscopic Biopsy With Normal Mucosa

Incidence of IBD elevated for at least 30 years for individuals with gastrointestinal biopsy of normal mucosa, indicating long symptomatic period before diagnosis
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Medically Reviewed By:
Mark Arredondo, M.D.

THURSDAY, March 2, 2023 (HealthDay News) -- Individuals with an endoscopic biopsy with normal mucosa have an increased risk for inflammatory bowel disease (IBD) for at least 30 years, indicating a substantial symptomatic period of IBD, according to a study published online Feb. 23 in PLOS Medicine.

Jiangwei Sun, Ph.D., from Karolinska Institutet in Stockholm, and colleagues examined the long-term risk for IBD after an endoscopic biopsy with normal mucosa during 1965 to 2016. A total of 200,495 and 257,192 individuals had lower or upper gastrointestinal (GI) biopsy of normal mucosa, respectively, and they were compared to their individually matched population references (989,484 and 1,268,897) and unexposed full siblings (221,179 and 274,529).

The researchers found that 4,853 individuals with lower GI biopsy of normal mucosa (2.4 percent) developed IBD during a median follow-up of approximately 10 years compared with 0.4 percent of the reference population. The corresponding incidence rates were 20.39 and 3.39 per 10,000 person-years. Compared with matched population references, exposed individuals had a persistently higher risk for overall IBD and for ulcerative colitis and Crohn disease (average hazard ratios, 5.56, 5.20, and 6.99, respectively). The average hazard ratios were 3.27, 3.27, and 3.77 for overall IBD, ulcerative colitis, and Crohn disease, respectively, in the sibling comparison. The average hazard ratio of Crohn disease was 2.93 and 2.39 for individuals with an upper GI biopsy of normal mucosa compared with population references and unexposed full siblings, respectively. The risk for IBD remained elevated for at least 30 years after cohort entry.

"Our findings may have important implications for both public health and clinical practice, as they might suggest a substantial symptomatic period before IBD diagnosis," the authors write.

Several authors disclosed financial ties to the biopharmaceutical and medical device industries.

Abstract/Full Text

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