Contact vulnerability of the intestinal mucosa in assessing the activity of inflammatory bowel diseases in children

Introduction. Inflammatory activity in ulcerative colitis (UC) and Crohn’s disease (CD) is assessed comprehensively using endoscopic, clinical, and laboratory parameters. Mucosal friability (MF), verified during colonoscopy, is an indicator of mucosal healing — the therapeutic goal in inflammatory bowel disease (IBD) and a significant prognostic factor for UC clinical outcomes. Aim: To evaluate the role of MF in determining IBD activity in children. Materials and methods. A clinical, prospective, observational cohort study included 81 IBD child, of whom 42 patients comprised the UC group and 39 the CD group. Disease activity was evaluated using pediatric clinical activity indices for UC and CD, as well as the endoscopic activity index for UC and the simple endoscopic score for CD. MF was assessed with a scale where 0 points corresponded to the absence of pathological changes, 1 point to intramucosal hemorrhages, and 2 points to contact bleeding. Results. In UC patients there were close positive correlations between the endoscopic activity of the disease and the severity of CD (p < 0.001; r = 0.713) and a moderate closeness between clinical activity and CD (p < 0.001; r = 0.503). In CD children, positive correlations of moderate crowding were found between the endoscopic activity of the disease and the severity of CD (p = 0.003; r = 0.464). However, in CD patients, the correlations between the clinical activity of the disease and CD are not significant (p = 0.184; r = 0.223). Conclusion. The determination of the contact difference to determine the healing of the mucous membrane in IBD is an informative method and has diagnostic significance in UC patients, in which the inflammatory process is located superficially in the mucous layer. The clinical interpretation of contact vulnerability requires mandatory comparison with clinical and anamnestic data and laboratory test results.