106 Intestinal Ultrasound in Obesity

Background: Intestinal ultrasound (IUS) has increasingly become more routine and an integral part of inflammatory bowel disease (IBD) patient care. More providers throughout the United States are becoming certified in IUS and incorporating ultrasound into their clinic and hospital care. IUS is non invasive and has been shown to accurately depict bowel wall inflammation with standardization by incorporating a universal Lindberg score and bowel wall measurements. While IUS is a helpful part of IBD patient care, there is limited data analyzing IBD patients with obesity. Historically, obesity can make ultrasound examinations difficult due to the shadowing effects from excess body habitus and limitations precluding adequate visualization of the targeted anatomy. Methods: Our study analyzes twenty- one patients with a diagnosis of IBD and obesity by using IUS to assess for active inflammation. IUS results were compared to fecal calprotectin results for standardization of inflammation. All fecal calprotectin results were captured within 3 months of IUS exam. Obesity was characterized as a body mass index (BMI) of 30 or over, with majority of patients having a BMI of 35 or greater. Results: Twenty-one patients were sorted based on IUS correlation with fecal calprotectin values. Six patients had elevated fecal calprotectin levels with active inflammation scored as a Lindberg 1 seen on IUS. Fifteen patients had normal fecal calprotectin levels with normal IUS exams scored as Lindberg 0. Conclusions: Our study supports the utilization of IUS for obese patients with IBD. The study exhibits the accuracy in assessing for inflammation with IUS being equivalent to fecal calprotectin levels. While fecal calprotectin levels and endoscopic assessments should continue to be used as this is a strong evidence based recommendation for IBD patients, our data in this study suggests that IUS is a valuable adjunct to accurately assess patients for the presence and localization of inflammation in an efficient manner for obese IBD patients.