Imaging in Inflammatory Bowel Disease (IBD)- A 4 way comparison study

Participants will undergo diagnostic assessments (colonoscopy, MRI, ultrasound and Pillcam Crohn's capsule) at 2 time points- 1 year apart. Colonoscopy, MRI and ultrasound all form part of routine disease assessment for patients with IBD and the use of these assessments during the study will not be different to standard care. The Pillcam Crohn's capsule is not yet part of routine care, but is merely an updated, higher definition iteration of existing capsule endoscopy systems. The risks associated with the Pillcam Crohn's capsule are no different to standard capsule endoscopy. Previous versions of capsule endoscopy have been shown to be comparable to other diagnostic modalities in the assessment of inflammatory burden in inflammatory bowel disease patients. The procedures will be performed within a 2 week period, so that they are able to be compared to each other as accurately as possible. There is no prescribed order of interventions, however the person reporting each intervention will be blinded to the results of the patient's other interventions. Colonoscopy- this is a standard diagnostic and therapeutic procedure for patients with inflammatory bowel disease. It involves taking a bowel cleansing preparation 1 day prior to the procedure. The procedure involves having a sedative medication administered and a camera with a light is inserted via the anus/rectum to pass through the entire large bowel. The large bowel and last few centimetres of the small bowel is examined by the colonoscope. The procedure usually takes between 15 to 45 minutes and will be performed by a gastroenterologist. Capsule endoscopy- This procedure involves having a similar bowel cleansing preparation as a colonoscopy. The patient will then ingest/swallow a capsule (that has a camera and light within it) and have a monitoring device attached to a waist belt. The capsule will take pictures of the patient's entire gastrointestinal tract and then pass in their stool into the toilet. The patient will then return the monitoring device to the hospital that same afternoon for uploading of the capsule pictures. This procedure will be facilitated by a gastroenterologist or a lab technician familiar with administering this test. The capsule procedure (from ingestion to excretion) usually takes 6-8 hours, but varies according to the individual. MRI- this is a diagnostic radiologic procedure that will be performed by radiographers. It involves lying in the MRI machine and having images taken of the patient's abdomen and internal organs. This procedure usually takes 40-60 minutes. Ultrasound- this is also a diagnostic radiologic procedure that will be performed by a gastroenterologist. This procedure involves having lubricating jelly applied to the patient's abdomen and an external probe placed on the abdomen to allow pictures to be taken of the patient's internal organs and intestines. This usually takes 10-20 minutes. No specific preparation is required for this procedure.