April 18, 2013
Story by Greg Harris; photo by Paul Rotzinger
Coreen Harbor has lived with Crohn’s disease since she was 18 years old and, over the ensuing 21 years, she has experienced her share of flareups.
The worst of them can require further diagnostic assessment, such as computed tomography (CT) scans or colonoscopies, both of which have their own discomforts and risks.
Now Harbor has the state of her inflammatory bowel disease (IBD) monitored with an old diagnostic standby – ultrasound.
“Ultrasound is a lot easier and kind of fun, too,” says the 39-year-old Calgary woman. “You can watch the screen and see what’s going on inside.”
Calgary has become one of the leading centres in the world in using this patient-friendly, non-invasive tool to monitor IBD, thanks to the pioneering efforts of radiologist Dr. Stephanie Wilson.
“One of the benefits of ultrasound is that it can really help doctors better manage these illnesses,” Dr. Wilson says. “They can get a clear indication of how a patient may be responding to a given therapy, and adjust treatment accordingly. Complications of disease are also well identified with ultrasound.”
Ultrasound can pinpoint flareups in inflammation before patients experience any symptoms, and it can also show that symptoms they may be experiencing aren’t due to any issues with their IBD.
Ultrasound can also provide information on blood flow, as well as detect bowel thickening – important disease indicators for doctors managing IBD patients.
“Calgary is probably the only place in the world that uses ultrasonography so much to monitor IBD, partly because of Dr. Wilson’s expertise, and partly because physicians like us think it gives us very useful information,” says Dr. Subrata Ghosh, a gastroenterologist and Calgary Zone clinical department head for AHS.
“It also has the advantage of being patient-friendly and non-invasive. Patients find it a much more engaging experience than something like an MRI or a CT scan.”
Learning how to use ultrasound in this way requires a minimum of six months of specialized training, over and above that of a general ultrasound operator. Dr. Wilson has trained several ultrasound technicians in the diagnostic imaging area of Foothills Medical Centre, which has a capacity to scan about 330 IBD patients a month.
“Although we’re a small unit, we provide a service here that is the envy of all of North America,” Dr. Wilson says. American physicians generally don’t utilize ultrasonography to monitor IBD, and only a handful of other places in Canada and Europe do.
Inflammatory bowel disease, a lifelong condition, is thought to be triggered by a complex interplay between genetics, diet, and the immune system. It can produce symptoms such as diarrhea, cramping and bleeding, and can be extremely debilitating. People with IBD have a higher risk of developing colorectal cancer.
Worldwide, IBD occurs most commonly in North America and Western Europe. It affects about 233,000 Canadians, or one in 150.
Dr. Wilson and one of her colleagues, Dr. Kerri Novak, recently summarized the benefits of using ultrasound to monitor IBD patients in a paper published in the peer-reviewed Journal of Ultrasound Medicine.
