P0438Making waves: Intestinal Ultrasound in the transition of care of Inflammatory Bowel Disease patients from paediatric to adult care in two centres

Abstract Background Transitioning from paediatric to adult care for Inflammatory Bowel Disease (IBD) patients can be a source of emotional stress for patients and families which can in turn lead to poor compliance and increased disease severity (1). Endoscopy is the gold standard test for monitoring disease activity in IBD patients but presents challenges particularly in a young population as it is invasive, requires bowel preparation and sedation (2). Availing of a non-invasive tool such as intestinal ultrasound (IUS) to assess disease activity in such a cohort could help to alleviate stress that can come with having invasive investigations. Additionally IUS has been shown to reduce time to clinical decision making and provide real-time information on disease activity and extent (3,4). Our aim was to review IUS scans performed on patients transitioning from paediatric to adult care and young adult IBD patients in two centres and its impact on clinical decision making. Methods We performed a retrospective review of IUS scans performed on IBD patients transitioning from paediatric care to adult care and scans performed on our young adult IBD patients. Baseline demographics were recorded including age, gender, disease subtype and current medications. We collected data relating to recent colonoscopy, capsule endoscopy or magnetic resonance enterography. We recorded findings on IUS and management plan thereafter. Results A total of 26 young adult or transition clinic patients with IBD had IUS scans performed. 30.7% were female and the median age was 17.5 (ICR: 16-21). 80.7% of patients had CD. Most patients were already on biologic therapy (88.8%, n = 23). Of these, 69% (n = 18) were on an anti-TNF agent. One patient was on Rizankizumab, one patient on Vedolizumab and three patients on Ustekinumab. Treatment changes occurred in 30.7% (n = 8) of patients after IUS was performed. Of these, IUS was adequate to decide on treatment changes for 6/8 (75%) patients without the need for colonoscopy. 4/8 were started on a biologic or switched out of class, two patients were started on steroids, one patient was dose optimised and one patient switched from intravenous infliximab to subcutaneous. Conclusion IUS is utilised as a real-time non-invasive tool in clinical decision-making for the young IBD patient in our centre. Integrating IUS into the transitional care of IBD patients could help to make more informed and rapid management decisions compared to less accessible and more invasive diagnostic tests. References: 1. Cole R, Ashok D, Razack A, et al. Evaluation of outcomes in adolescent inflammatory bowel disease patients following transfer from paediatric to adult health care services: case for transition. J Adolesc Health 2015;57:212-217. 2. Hart L, Nael H, Longmire NM, et al. Barriers and facilitators to a good bowel preparation for colonoscopy in children: a qualitative study. J Pediatr Gastroenterol Nutr. 2018;67:188-193. 3. Novak K, Tanyingoh D, Peterson F, et al. Clinic-based point of care transabdominal ultrasound for monitoring Crohn’s disease: impact on clinical decision making. J Crohns Colitis 2015;9:795-801. 4. Kucharzik T, Taylor S, Allocca M, et al. ECCO-ESGAR-ESP-IBUS Guideline on Diagnostics and Monitoring of Patients with Inflammatory Bowel Disease: Part 1: initial diagnosis, monitoring of known inflammatory bowel disease, detection of complications. J Crohns Colitis 2025;19:jjaf107. Conflict of interest: Dr. Kerr, Hilary: No conflict of interest Nwaezeigwe, Mary: No conflict of interest Hanly, Micheal: No conflict of interest Hamzawi, Mary: No conflict of interest Mulcahy, Hugh: No conflict of interest Donnellan, Fergal: No conflict of interest Horgan, Gareth: No conflict of interest O’Reilly, Susanne: No conflict of interest McDermott, Edel: No conflict of interest Sheridan, Juliette: No conflict of interest Cullen, Garret: No conflict of interest Rowan, Catherine: No conflict of interest Doherty, Glen: Research or Education Grants (last 36 months): Abbvie, Pfizer, Janssen, Takeda, Tillotts, Celltrion, Abbott, Dr Falk, Amgen Speaker/Meeting Honoraria (Last 36 months): Abbvie, Dr Falk, Galapagos/Alfa Sigma, GSK