Article Highlights

• Intestinal ultrasound is a point-of-care modality that enables real-time assessment of IBD activity during routine clinic visits.
• The technique evaluates bowel wall thickness, inflammation and complications (e.g., strictures, fistulas, abscesses) across the small and large intestine.
• Immediate visualization supports same-visit therapeutic decision-making without waiting for endoscopy or biopsy results.
• Intestinal ultrasound can detect subclinical inflammation, allowing earlier intervention even in asymptomatic patients.
• As a noninvasive, no-prep alternative to colonoscopy, it lowers patient burden while facilitating more frequent disease monitoring.

 

Over the past four years, intestinal ultrasound (IUS) has gained significant traction in high-volume academic centers across the U.S. as a noninvasive, real-time tool for monitoring inflammatory bowel disease (IBD). However, its adoption in private practice remains limited. Dr. Bincy Abraham, director of the Houston Methodist Underwood Center's Fondren Inflammatory Bowel Disease Center and a national leader in IUS, is working to change that.

"Houston Methodist was the first center in Texas to incorporate intestinal ultrasound in practice, and since then, it's really been a mission of mine to train providers in learning intestinal ultrasound," says Dr. Abraham.

(Related: AGA Issues Clinical Practice Update Embracing Use of Ultrasound for Management of IBD)

In a video highlighting a recent training session, Dr. Abraham and her colleagues explain why IUS is a game changer and the importance of expanding access and training to gastroenterologists across the country.

A point-of-care revolution in IBD management

Intestinal ultrasound is a noninvasive, real-time imaging modality that enables clinicians to evaluate and monitor IBD during a standard clinic visit.

"This is simply an abdominal ultrasound where we're using a traditional ultrasound machine with abdominal probes to specifically look at the intestines, both the small intestine and the large intestine," explains Dr. Abraham.

The technique provides immediate insight into disease activity by identifying bowel wall thickening, mesenteric fat, strictures, fistulas and abscesses. This immediacy enables real-time changes to clinical care.

“It provides a huge benefit for our patients to have a noninvasive, earlier way of managing their disease, and for providers to offer this to our patients within a clinic setting.”

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Dr. Bincy Abraham

"I'm able to provide them changes to their therapy right at that clinic visit," she says. This allows for timely treatment adjustments without waiting for biopsy results or advanced imaging.

IUS also enables earlier intervention in asymptomatic patients. "Some patients may not have clinical symptoms but have active inflammation," Dr. Abraham notes. "We're able to treat their disease earlier before their quality of life suffers."

Bridging the training gap

When Dr. Abraham first pursued IUS training, no programs existed in the U.S. "I had to go internationally to learn this," she recalls, referencing her experience with the International Bowel Ultrasound Group (IBUS).

To address this gap, Houston Methodist recently hosted IBUS Module 1 training — a three-day intensive course featuring lectures from leaders in IUS and hands-on sessions practicing with the technology.

The course is designed to give gastroenterologists foundational skills in IUS, enabling them to begin integrating the modality into their own practices. While attendees are not expected to become experts in just a few days, the training provides the confidence and competence to pursue further certification and clinical implementation.

Looking ahead

The momentum around IUS continues to build. "We've gotten significant interest across the U.S., especially amongst our IBD specialists," says Dr. Abraham. "We've started training a number of providers in this, both in the pediatric and the adult IBD centers."

For Dr. Abraham, education and advocacy are central to her mission.

As IUS gains traction in the U.S., Houston Methodist's pioneering efforts are setting a new standard for IBD care — one that is faster, more responsive and deeply patient-centered.