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  • Q&A with Australian Health Practitioners

    How often should I have a colonoscopy if I have Crohn's disease?

    Related Topics
    Crohn's Disease & Ulcerative Colitis Digestive Health
    I understand that my risk of colon cancer is higher than the average person's as I have Crohn's disease. How often should I have a colonoscopy?
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    A/Prof Greg Moore

    Gastroenterologist

    Greg Moore is a Gastroenterologist specialising in Inflammatory Bowel Diseases (IBD), Crohn's Disease and Ulcerative Colitis. He is Head of IBD at Monash Medical Centre … View Profile

    The timing of colonoscopy in Crohn's disease depends on several factors. Colonoscopy is performed to assess which parts of the lower bowel (rectum, colon and terminal ileum (end of the small bowel)) are affected to:
    1) initially make a diagnosis,
    2) assess the effectiveness of treatment
    3) to assess whether ongoing symptoms such as pain and diarrhoea are due to active Crohn's inflammation in order to guide a change in therapy, or from any complications such as strictures (narrowings) in the bowel.
    4) assess if there are changes in the bowel that might increase the risk of bowel cancer.  This is usually only done in patients where extensive amounts of the colon is involved.  There is a small increase in the chance of developing colon cancer after many years (usually more than 10) of disease in these patients.  In this situation, colonoscopy is usually performed yearly from 8 to 10 years since diagnosis.

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    Dr Kannan Venugopal

    Gastroenterologist

    I am an adult gastroenterologist working in Perth, WA. I have trained in Perth and Edinburgh, UK. After completing my speciality gastroenterology training, i have … View Profile

    Crohn's disease can affect any part of the alimentary tract, from the oral cavity to the rectum/ anal canal. The frequency at which colonoscopy is required in a patient with Crohn's disease is determined by the disease severity in itself. Typically, colonoscopy is done ( once the diagnosis is established) to
    1. Look for evidence of inflammation or healing.
    2. Assess for complications of crohn's disease- ie, strictures and for its treatment, for eg: dilatation of strictures.
    3. To ascertain treatment efficacy ( typically before a step down in treatment is considered)
    4.If Crohn's disease affects the colon predominantly, inflammation in this region can predispose to
    development of bowel cancer and patients are placed on a colonoscopy surveillance protocol to detect these changes early.
    Colonoscopy, therefore, is commenced usually at 8-10 yrs post diagnosis in patients with colonic Crohn's disease and 1-2 yearly thereafter ( the frequency of ongoing surveillance is determined by the severity of inflammation, family history of bowel cancer etc) In patients with isolated Crohn's disease of the small bowel, the value of surveillance colonoscopy is not as well established as in patients with Colonic crohn's disease.

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