During an acute ulcerative colitis flare, which diagnostic procedure is contraindicated?

During an acute ulcerative colitis flare, which diagnostic procedure is contraindicated?

• A. Colonoscopy
• B. Abdominal X-ray
• C. CBC
• D. Stool studies

Answer: (A)

In an acute ulcerative colitis flare, the colon is inflamed and friable, often with wall edema and potential dilation if the disease is severe. Introducing a scope with insufflation and tight instrumentation can provoke perforation or worsen toxic megacolon. That risk makes endoscopic evaluation—colonoscopy—contraindicated during a severe flare. Instead, use noninvasive or less invasive assessments to guide management: an abdominal X-ray can detect colonic dilation suggestive of toxic megacolon, CBC helps assess leukocytosis and anemia, and stool studies help rule out infectious causes that can mimic or trigger a flare. Once the patient is stabilized and inflammation subsides, colonoscopy can be considered if mucosal assessment or biopsies are needed.

In an acute ulcerative colitis flare, the colon is inflamed and friable, often with wall edema and potential dilation if the disease is severe. Introducing a scope with insufflation and tight instrumentation can provoke perforation or worsen toxic megacolon. That risk makes endoscopic evaluation—colonoscopy—contraindicated during a severe flare. Instead, use noninvasive or less invasive assessments to guide management: an abdominal X-ray can detect colonic dilation suggestive of toxic megacolon, CBC helps assess leukocytosis and anemia, and stool studies help rule out infectious causes that can mimic or trigger a flare. Once the patient is stabilized and inflammation subsides, colonoscopy can be considered if mucosal assessment or biopsies are needed.