GIE Editor-in-Chief, Dr. Michael Wallace, highlights this article from the December issue “The emerging role of histologic disease activity assessment in ulcerative colitis” by Rish K. Pai, MD, PhD, et al. 

The decision about when to start and stop therapy for ulcerative colitis is increasingly made based on colonoscopy and histological assessment of activity (“treat to target”). Although this is highly valuable, the methods of histological classification of activity are poorly described and standardized, as are biopsy protocols. This article, by leading GI pathologists, describes the current state of the art for histological assessment in UC and recommendations for standard biopsy protocols.

Most GI physicians take care of patients with UC, so knowing when to stop or convert therapy is core to our practice. Since those decisions are guided by histology, it is critical that GI physicians understand how histology is scored and how to best provide proper biopsy specimens.

Before stopping or converting therapy in IBD, colonoscopy with biopsy should be considered. Specimens provided to the pathology department should sample all regions of the colon, including ulcer edges and all affected regions. If not done previously, biopsies from unaffected areas should also be obtained and placed in standard specimen jars by location. We would suggest that GI physicians share this article with their pathology colleagues to standardize reporting.

Read the article abstract here.

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