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Letter to the Editor
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Response: Comments on “Adequacy of sigmoidoscopy as compared to colonoscopy for assessment of disease activity in patients of ulcerative colitis: a prospective study”
Sameet Tariq Patel,orcid, Sanjay Chandnaniorcid, Pravin M Rathiorcid
Intestinal Research 2025;23(2):227-228.
DOI: https://doi.org/10.5217/ir.2024.00209
Published online: April 29, 2025

Department of Gastroenterology, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, India

Correspondence to Sameet Tariq Patel, Department of Gastroenterology, Topiwala National Medical College and BYL Nair Charitable Hospital, Dr A Nair road, Mumbai central, Mumbai 400008, India. E-mail: sameetpat8@gmail.com
• Received: December 5, 2024   • Accepted: December 26, 2024

© 2025 Korean Association for the Study of Intestinal Diseases.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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See the letter "Comments on “Adequacy of sigmoidoscopy as compared to colonoscopy for assessment of disease activity in patients of ulcerative colitis: a prospective study”" on page 225.
We thank Dr Harindranath for his invaluable comments on our study [1]. The author has stated the fact that sigmoidoscopy is adequate for follow-up cannot be extrapolated from the results of the current study. However, as sigmoidoscopy was compared with colonoscopy on follow-up evaluation during the disease course of ulcerative colitis, the conclusion of adequacy of sigmoidoscopy has been reasonably reached given strong agreement [2].
The author has stated that the study lacks stratification based on disease extent like the study by Park et al. [3], however, the inclusion criteria of our research itself included patients with disease extent beyond the sigmoid colon at index colonoscopy. It has been stated in the study by Patel et al. that a limitation of the previous study by Park et al. is its inclusion of number of patients with proctitis being as high as 41.2% and left-sided colitis (29.6%). This created a bias by assessing patients with a disease limited to the rectosigmoid. The author has gone on to state the therapeutic implications of extensive colitis in comparison to left-sided colitis which is distinct from the basis of the current study, which states that in patients with disease extent beyond the sigmoid colon, a follow-up sigmoidoscopy is adequate to assess the variable disease severity.
The author has stated that most patients included in the study had mild disease as evidenced by low Mayo endoscopic sub-scores, that they are more likely to require colonoscopy and that it differs from real-world data. However, most of our patients had moderate disease (as per the median Mayo endoscopic subscore [MES] of 2). Active disease (MES>0) was present in 96 patients (96%) and disease was in remission (MES=0) in 4 patients (4%). Considering active disease as MES >1, active disease was present in 72 patients (72%) and disease was in remission in 28 patients (28%). The higher number of patients with active disease during follow-up of ulcerative colitis patients in our study represents the real-world data from our part of the world.

Funding Source

The author received no financial support for the research, authorship, and/or publication of this article.

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Data Availability Statement

Data will be made available upon reasonable request to corresponding author.

Author Contributions

Writing - original draft: Patel ST. Writing - review & editing: Chandnani S, Rathi PM. Approval of final manuscript: all authors.

  • 1. Harindranath S. Comments on “Adequacy of sigmoidoscopy as compared to colonoscopy for assessment of disease activity in patients of ulcerative colitis: a prospective study”. Intest Res 2025;23:225–226.ArticlePubMedPDF
  • 2. Patel ST, Jena A, Chandnani S, et al. Adequacy of sigmoidoscopy as compared to colonoscopy for assessment of disease activity in patients of ulcerative colitis: a prospective study. Intest Res 2024;22:310–318.ArticlePubMedPMCPDF
  • 3. Park SB, Kim SJ, Lee J, et al. Efficacy of sigmoidoscopy for evaluating disease activity in patients with ulcerative colitis. BMC Gastroenterol 2022;22:83.ArticlePubMedPMCPDF

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