Published online Jun 16, 2019. doi: 10.4253/wjge.v11.i6.424
Peer-review started: May 8, 2019
First decision: May 31, 2019
Revised: June 5, 2019
Accepted: June 10, 2019
Article in press: June 10, 2019
Published online: June 16, 2019
Patients with inflammatory bowel diseases (IBD) represent heterogeneous groups with different characteristics and different clinical course. A great deal of effort is made to discover proxies for more severe disease needing more intense treatment and early intervention to gain the maximum therapeutic benefit. Endoscopy remains an invaluable method in assessment of patients with IBD. Pseudopolyps are often encountered during endoscopy and, although they are a well described entity, their presence is of unclear importance. In one of our recent studies and in conjunction with one study with a large cohort of patients with IBD and pseudopolyps, patients with pseudopolyps were found to face a higher inflammatory burden in terms of receiving more intense biological treatment. This letter comes as a comment and proposition regarding the concept of re-evaluation of pseudopolyps as a promising marker in IBD scores.
Core tip: Interest in pseudopolyps and their relationship for monitoring inflammatory bowel disease activity has been refreshed by two recent studies that showed the presence of pseudopolyps to be linked with escalation of treatment, including the increased need for use of biological agents. The next logical step in their management is including their evaluation and possible integration, after proper validation, in inflammatory bowel disease scores, as separate markers for prediction of a more severe clinical course.