Learn how pathology works to identify inflammatory bowel diseases

The work of pathology consists of analyzing the material collected by the endoscopist, from parts of the intestine or other parts of the gastrointestinal tract. “Knowing the clinical information, such as the symptoms presented by the patient and if there are any changes in the upper digestive endoscopy or colonoscopy, are essential for us to be able to make an accurate diagnosis”, explains the pathologist, Lauren Menna Marcondes.


In ulcerative colitis, the more superficial layers (mucosa and submucosa) that line the intestine may be affected and inflamed. Usually, the rectum is compromised with inflammation, which extends along the colon.

In Crohn’s disease, all intestinal layers may be involved, such as mucosa, submucosa, muscularis and serosa. Patients can also develop fistulas, which are extremely painful. Another differentiating factor is that it can occur anywhere in the gastrointestinal system, that is, from the mouth to the anus. “It is not uncommon to find fistulas from the intestine to the vagina or bladder, for example”, points out the pathologist, Beatriz Moreira Leite.

According to the specialist, if the doctor has doubts between the diseases, he forwards the characteristics he found during the endoscopy and the pathologist can analyze the tissue in the biopsy in detail. “Some features can be found in both diseases if it is early in the inflammation. It is important to follow the evolution of the patient’s clinical condition, as the diagnosis is supported on the tripod: clinical data (patient symptoms), endoscopy findings and biopsy analysis”, she emphasizes.

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“The diseases are chronic, in addition, the patient diagnosed with inflammatory bowel disease is more likely to develop colon cancer in the future, since the disease is a risk factor due to the continuous aggression of the organ”, according to the medical pathology. , Paula de Carvalho.

Follow-up and remission

Although there is no cure, the disease is treatable. There are many cases of patients in remission. Even so, they undergo follow-up by doctors and carry out periodic examinations to identify whether the disease is active again.

“With the tissue collected in the biopsy, we analyzed and were able to identify whether the disease is active again before the patient even feels symptoms. In these cases, the doctor starts the most intense treatment”, concludes the doctor Beatriz.