New AGA guideline recommends blood and stool tests for monitoring ulcerative colitis
In new evidence-based guidelines, the American Gastroenterological Association (AGA) recommends non-invasive biomarkers as a first-line strategy for monitoring many patients with ulcerative colitis (UC). These guidelines were published today in Gastroenterology.
The AGA guidelines outline use cases for three biomarkers that provide accurate insights into ulcerative colitis disease activity: serum C-reactive protein (CRP) (blood), fecal calprotectin (stool) and fecal lactoferrin (stool).
AGA recommends a monitoring strategy that integrates non-invasive biomarkers for patients with ulcerative colitis in remission (no current symptoms) as well as those with current symptoms.
Patients with ulcerative colitis in symptomatic remission:
- Perform interval biomarker monitoring every six to 12 months.
- AGA recommends stool-based biomarkers over blood testing.
- If biomarkers are normal, AGA suggests continuing biomarker monitoring and avoiding routine endoscopic assessment.
- If biomarkers are elevated, AGA suggests endoscopic assessment by a gastroenterologist.
- Listen to your body! Talk to your doctor about any new symptoms.
Patients with symptomatically active ulcerative colitis:
- Biomarker testing should be the first step to determine the need for endoscopic assessment.
- For patients with mild symptoms who have normal or elevated biomarkers, AGA suggests endoscopic assessment by a gastroenterologist.
- For patients with moderate to severe symptoms who have normal biomarkers, AGA suggests endoscopic assessment by a gastroenterologist.
- For patients with moderate to severe symptoms and elevated biomarkers, AGA suggests treatment adjustment and avoiding endoscopic assessment.
