Ultrasound is Transforming Care for Inflammatory Bowel Disease

Ultrasound is a medical technology well-known as a tool for monitoring pregnancy. But it has expanded into other areas, including gastroenterology (the care of the digestive system), where it is transforming how doctors monitor chronic conditions like inflammatory bowel disease (IBD). Ultrasound is now providing insights into the body’s intestines, which helps patients get the help they need, quickly.

“Intestinal ultrasound is essentially an advanced form of the traditional stethoscope,” says pediatric gastroenterologist Joseph Picoraro, MD. “It’s been around for a long time, but in the last 20 years we’ve seen significant advancements in ultrasound’s ability to detect and monitor disease in the GI system.”

Dr. Picoraro explains how the detailed images ultrasound provides are revolutionizing care, particularly for patients with chronic gastrointestinal conditions.

What is intestinal ultrasound, and how does it work?

Intestinal ultrasound is a non-invasive, real-time imaging tool that uses sound waves to “see” what's going on inside the intestines.

It’s becoming a routine part of doctor visits in areas it hadn’t been previously. As the technology continues to improve and becomes more affordable, we’ll likely see it become a standard tool in gastroenterology and other specialties.

How is intestinal ultrasound different from other imaging technologies like MRIs or CT scans?

The main differences are accessibility and cost.

MRI is the gold standard for diagnosing IBD because it gives a comprehensive view of the intestine. But it’s expensive, time-consuming, and not always feasible, especially for children.

Intestinal ultrasound, unlike MRIs, can happen right in the clinic, which makes the process much more efficient and less stressful for patients. It’s also faster and doesn’t require drinking a large amount of liquid contrast.

Plus, it is far more comfortable for patients—especially kids. I’ve had instances where a child falls asleep during the ultrasound because it’s so comfortable. It’s a stark contrast to the anxiety patients often feel with more invasive tests.

How is intestinal ultrasound used by GI doctors, particularly for IBD?

GI doctors typically use ultrasound to monitor the progress of IBD after a diagnosis is made. For example, after starting a patient on medication, we might do an ultrasound after 10-12 weeks to see how the intestine is responding. It helps us figure out if the treatment is working or if we need to adjust it.

Is intestinal ultrasound used in hospitals and doctor’s offices?

Yes, especially in Europe, ultrasound has been widely adopted in gastroenterology.

At Columbia, we integrated ultrasound machines into our clinics in April 2024. So, we can conduct ultrasounds as part of the regular patient visit, making the technology more accessible and cost-effective.

What are the benefits of using intestinal ultrasound during patient visits?

Intestinal ultrasound transforms the entire experience.

One of the major benefits of using it right there in the office during the patient visit is that our treatment team can explain what we’re seeing in real time. That helps us make decisions on the spot and helps patients and their families be more connected to their care.

By integrating intestinal ultrasound into routine visits, we’re able to offer more personalized, real-time care.

How does intestinal ultrasound impact the lives of patients with IBD?

IBD, which includes Crohn’s disease and ulcerative colitis, is lifelong and often requires constant monitoring. Traditional diagnostic methods, like colonoscopies and blood tests, can’t always detect subtle changes early enough.

Intestinal ultrasound allows us to see inflammation or complications as they develop, sometimes before a person feels symptoms. Early detection helps us adjust treatment plans more quickly, ensuring that we’re keeping the disease under control and minimizing complications.

Ultrasound doesn’t involve any prep, needles, or invasive tools. It’s a gentle procedure.

What’s next for the use of ultrasound to treat IBD and other gastrointestinal conditions?

We’re just scratching the surface. Research is ongoing. We’re beginning to see how ultrasound can predict disease flares or how well a patient is responding to treatment. 

It’s still an evolving field, and part of the challenge is ensuring that the right staff members are trained to use it, but the impact on patient care is already significant. The hope is that in the future we can use ultrasound not just for diagnosis but more as a monitoring tool that replaces the need for invasive tests every few months.

With advancements in this technology, the possibilities are endless.

Joseph Picoraro, MD, is an associate professor of pediatrics at Columbia and director of the Pediatric IBD Center at Columbia. He specializes in conditions that affect the gastrointestinal (GI) tract, with a focus on inflammatory bowel disease (IBD).