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Intestinal ultrasound (IUS) is increasingly used by gastroenterologists and point-of-care clinicians to assess disease activity in inflammatory bowel disease (IBD) — Crohn’s disease and ulcerative colitis — without the radiation of CT or the preparation and cost of colonoscopy.

Performed at the bedside or in clinic, IUS gives an immediate, repeatable picture of what’s happening in the bowel wall.

• Bowel Wall Thickness (BWT): the single most reproducible marker of disease activity. A normal bowel wall measures under 3 mm; in active IBD, thickening beyond this threshold is a key diagnostic sign.
• Bowel wall stratification: a healthy bowel wall shows distinct layers on ultrasound. Loss of this normal stratification pattern
  correlates with more severe, transmural inflammation.
• Color Doppler signal (hyperemia): increased blood flow in the bowel wall — often graded with scores such as the Limberg score —reflects active inflammation and helps distinguish active disease from fibrotic, burnt-out segments.
• Mesenteric changes: hypertrophy of the surrounding mesenteric fat (“creeping fat”) is a further sign of chronic inflammatory activity.
• Complications: IUS can also identify strictures, fistulas and abscesses — findings that directly change management.

Unlike colonoscopy or CT enterography, IUS can be repeated as often as needed, at no radiation cost to the patient, to monitor whether a
treatment is working — often within weeks of starting therapy.

This makes it a natural fit for the same point-of-care philosophy WINFOCUS teaches across critical care and emergency ultrasound: a fast, focused answer, obtained and interpreted by the treating clinician, that changes what happens next for the patient.

WINFOCUS’s next live Masterclass, Intestinal Ultrasound in IBD: How the Experts Do It, brings together Dr. Cindy Law (Massachusetts General Hospital & Harvard Medical School) and Dr. Kerri Novak (University of Calgary, Division of Gastroenterology and Hepatology) to walk through these techniques in a live, case-based session — free for WINFOCUS Associate members.