Do you see what I see?
An assessment of endoscopic lesions recognition and description by gastroenterology trainees and staff physicians
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15 minutes of your time will be rewarded with a $15 starbucks gift card (for the first 100 participants)
**For more details about the study, please scroll to the bottom of this document**

Thank you for your participation.

Sincerely,

Dr. Talat Bessissow, Dr. Lara Hart, Dr. Mallory Chavannes

Division of Gastroenterology, McGill University
Division of Gastroenterology, University of British Columbia
Pre-questionnaire demographics
1. Please indicate your age:
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2. Please indicate the number of years of practice:
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3. Please indicate your area of practice:
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4. In what kind of center do you practice?
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5. Did you complete an additional fellowship in Inflammatory Bowel Disease?
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6. Do you supervise fellows?
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7. Please indicate the estimated number of colonoscopies you complete per year
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8. Which ulcerative colitis endoscopy scoring system do you use?
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9. Do you feel comfortable using the score in question 8?
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10. Which crohn’s disease endoscopy scoring system do you use?
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11. Do you feel comfortable using the score in question 10?
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12. Do you use the same endoscopy scoring systems for patients in remission?
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13. If no, why not?
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14. How often do you use an IBD endoscopy scoring system?
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15. If you are using the IBD endoscopy scoring system, 50% of the time or less, please indicate the reason(s) why.
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16. How did you decide which scoring systems to use?
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17. When describing endoscopic lesions, which words/terms do you use most often for UC?
18. When describing endoscopic lesions, which words/terms do you use most often for crohn's disease?
Part 1: Ulcerative colitis
1a. 25 yo M, ulcerative colitis - please describe the findings (check all that apply)
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1aa. If ulcers are present, how would you classify them:
1b. Based on this image (for this segment of bowel), how would you score this?
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1c. Based on this image alone (irrespective of your answer to 1b), how severe is the disease activity?
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1d. This patient has a 2 year history of extensive ulcerative colitis. On adalimumab 40mg q2wk for the past 8 months. Colonoscopy for assessment of mucosal healing. FC 270. How would you treat?
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2a. 23 yo M, ulcerative colitis - please describe the findings (check all that apply)
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2aa. If ulcers are present, how would you classify them:
2b. Based on this image (for this segment of bowel), how would you score this?
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2c. Based on this image alone (irrespective of your answer to 2b), how severe is the disease activity?
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3a. 50 yo M, ulcerative colitis - please describe the findings (check all that apply)
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3aa. If ulcers are present, how would you classify them:
3b. Based on this image (for this segment of bowel), how would you score this?
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3c. Based on this image alone (irrespective of your answer to 3b), how severe is the disease activity?
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4a. 44 yo F, ulcerative colitis - please describe the findings, assuming the surface has been properly washed (check all that apply)
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4aa. If ulcers are present, how would you classify them:
4b. Based on this image (for this segment of bowel), how would you score this?
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4c. Based on this image alone (irrespective of your answer to 4b), how severe is the disease activity?
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5a. 60 yo F, ulcerative colitis - please describe the findings (check all that apply)
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5aa. If ulcers are present, how would you classify them:
5b. Based on this image (for this segment of bowel), how would you score this?
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5c. Based on this image alone (irrespective of your answer to 5b), how severe is the disease activity?
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5d. Patient has had 8 years of UC, compliant on azathioprine, no symptoms, normal bloodwork. Screening colonoscopy for dysplasia. How would you treat?
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6a. 16 yo M, ulcerative colitis - please describe the findings, assuming the surface has been properly washed (check all that apply)
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6aa. If ulcers are present, how would you classify them:
6b. Based on this image (for this segment of bowel), how would you score this?
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6c. Based on this image (irrespective of your answer to 6b), how severe is the disease activity?
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6d. Patient has had 2 year history of colitis. Taking 5ASA. Started experiencing progressively worsening symptoms; now having 8-12 loose bloody bowel movements per day. FC >2100, stool for infectious workup negative. CRP 55, Hgb 109, albumin 33. How would you treat - what would you do first?
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7a. 35 yo F, ulcerative colitis - please describe the findings (check all that apply)
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7aa. If ulcers are present, how would you classify them:
7b. Based on this image (for this segment of bowel), how would you score this?
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7c. Based on this image (irrespective of your answer to 7b), how severe is the disease activity?
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7d. This patient has had a 2 year history of extensive ulcerative colitis. On infliximab for the past 8 months, 10mg/kg q8weeks. Colonoscopy for assessment of mucosal healing. IFX level 7. How would you treat?
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8a. 14 yo M, ulcerative colitis - please describe the findings, assuming the surface has not been washed (check all that apply)
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8aa. If ulcers are present, how would you classify them:
8b. Based on this image (for this segment of bowel), how would you score this?
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8c. Based on this image (irrespective of your answer to 8b), how severe is the disease activity?
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8d. This patient has been on infliximab since his diagnosis 2 years ago, as he presented in fulminant colitis. Receives 7.5mg/Kg q5 weeks. Symptoms are manageable with 3 semi-formed BM per day and no blood and a CRP = 6. Recent fecal calprotectin improved from 1800 to 965. Reassessment of disease burden. IFX level = 0.7 and high antibodies. How would you treat?
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9a. 27 yo F, ulcerative colitis - please describe the findings (check all that apply)
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9aa. If ulcers are present, how would you classify them:
9b. Based on this image (for this segment of bowel), how would you score this?
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9c. Based on this image (irrespective of your answer to 9b), how severe is the disease activity?
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9d. This is a patient with extensive colitis, initially presented for acute severe colitis. Has been well controlled on azathioprine monotherapy since with adequate levels (6TG 330). She has 3 months of increased blood in her stool and tenesmus. She is well hydrated. FC 956, with otherwise normal blood work. Colonoscopy to reassessment of disease burden. What would you do first?
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*Mayo endoscopic score: Schroeder KW et al. NEJM 1987.
Part 2: Crohn's disease
1a. 21yo F, crohn's disease - please describe the findings (check all that apply)
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1i. If ulcers are present, please classify:
1ii. If ulcers are present, how much surface do the ulcers take?
1iii. If inflammatory changes are present, what percent of the surface is involved?
1b. Based on the image (for this segment of bowel), how would you score this lesion?
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1c. Based on the image (irrespective of your answer to 1b), how severe is the disease activity?
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1d. Patient know to have ileocolonic CD for 2 years. On adalimumab monotherapy 40mg q1wk for the past year (no previous use of infliximab). Worsening symptoms of diarrhea and weight loss over the last 6 weeks. CRP 15. FC 700. adalimumab level 0.7 with high antibodies. Colonoscopy to assess for disease severity. How would you treat?
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2a. 35yo F, crohn's disease - please describe the findings in the cecum (check all that apply)
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2i. If ulcers are present, please classify
2ii. If ulcers are present, how much surface do the ulcers take:
2iii. If inflammatory changes are present, what percent of the surface is involved?
2b. Based on the image (for this segment of bowel), how would you score this?
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2c. Based on the image (irrespective of your answer to 2b), how severe is the disease activity?
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2d. This patient has had 5 years of ileocolonic CD, on infliximab for 2 years, currently on 5mg/kg q6wk. Recent increase in frequency of bowel movements, with occasional diarrhea. Normal bloodwork. FC 335. IFX level 2.9. How would you treat?
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3a. 18yo M, crohn's disease - please describe the findings in the ileum, assuming the surface has been properly washed (check all that apply)
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3i. If ulcers are present, please classify
3ii. If ulcers are present, how much surface do the ulcers take:
3iii. If inflammatory changes are present, what percent of the surface is involved?
3b. Based on the image (for this segment of bowel), how would you score this?
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3c. Based on the image (irrespective of your answer to 3b), how severe is the disease activity?
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4a. 50yo M, crohn's disease - please describe the findings in the ileum (check all that apply)
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