Bronze Sergio, Shenoy Shabari, Agrawal Manasi, Polydorides Alexandros D, Colombel Jean-Frédéric, Rodríguez-Lago Iago, Ungaro Ryan C
Gastroenterology and Hepatology Department, Unidade Local de Saúde de Santa Maria, Lisbon, Portugal.
Faculdade de Medicina de Lisboa, Lisbon, Portugal.
Dig Dis Sci. 2025 Sep 19. doi: 10.1007/s10620-025-09400-5.
Inflammatory bowel disease (IBD) can be detected in the absence of clinical symptoms.
To determine the prevalence of incidental IBD in patients undergoing screening colonoscopy and to explore its clinical features and long-term outcomes.
We conducted a retrospective cohort study that included all asymptomatic adults who underwent colonoscopy for colorectal cancer screening or polyp surveillance between 2009 and 2023 in a large health system. Incidental IBD was defined as endoscopic and histologic findings consistent with the disease in the absence of symptoms. Clinical characteristics and outcomes were collected.
Among 40,573 patients who underwent colonoscopy, 60 were diagnosed with incidental IBD: 40 with Crohn's disease (CD), 10 with ulcerative colitis (UC), and 10 with IBD-unclassified (IBD-U). Mean age at diagnosis was 54.6 years for CD, 52.8 years for UC, and 55.7 years for IBD-U, with an overall female predominance (53%). Most CD patients had ileal involvement (98%) and inflammatory behavior (98%), and 60% of UC patients had extensive disease. After a mean follow-up period of 27.9 ± 34.7 months, 10 (16.7%) patients developed symptoms, and 5 (8.3%) initiated therapy, mostly after symptom onset. No hospitalizations or surgeries were reported.
The prevalence of incidental IBD detected during colorectal cancer screening is low (0.15%), with 20% of CD and 20% of UC cases progressing to symptomatic disease. Incidental IBD has a mild disease course with a low likelihood of progression to complications.
炎症性肠病（IBD）可在无临床症状的情况下被检测到。
确定接受结肠镜筛查的患者中偶发性IBD的患病率，并探讨其临床特征和长期预后。
我们进行了一项回顾性队列研究，纳入了2009年至2023年期间在一个大型医疗系统中因结直肠癌筛查或息肉监测而接受结肠镜检查的所有无症状成年人。偶发性IBD被定义为在无症状情况下内镜和组织学检查结果符合该病。收集了临床特征和预后情况。
在40573例接受结肠镜检查的患者中，60例被诊断为偶发性IBD：40例为克罗恩病（CD），(10)例为溃疡性结肠炎（UC），(10)例为未分类的IBD（IBD-U）。CD诊断时的平均年龄为54.6岁，UC为52.8岁，IBD-U为55.7岁，总体上女性占优势（53%）。大多数CD患者累及回肠（98%）且具有炎症性表现（98%），60%的UC患者患有广泛性疾病。在平均随访27.9±34.7个月后，10例（16.7%）患者出现症状，5例（8.3%）开始治疗，大多在症状出现后。未报告住院或手术情况。
在结直肠癌筛查期间检测到的偶发性IBD患病率较低（0.15%），20%的CD和20%的UC病例进展为有症状疾病。偶发性IBD病程较轻，进展为并发症的可能性较低。
