Reclassifying Pseudopolyps in Inflammatory Bowel Disease: Histologic and Endoscopic Description in the New Era of Mucosal Healing

Abstract Introduction In this study, we identify the frequency of pseudopolyps (PPs) with normal histology and their association to surrounding tissue. Methods Patients were enrolled in a study identifying endoscopic characteristics of PPs (n = 29) or were collected as part of our IBD biobank (n = 16). Statistical analysis included Stata v.15.0. chi-square and Student t-test. Results A total of 45 patients with 117 PP biopsies were identified. More patients with healed PP were in endoscopic remission compared with those with inflammatory PP (82.6% vs 17.4%, respectively). Conclusion This is the first study to find mucosal healing of PPs and its association with deep remission. Lay Summary “Healed” pseudopolyps, which are projecting masses of scar tissue developed during the healing phase of IBD, were detected in patients with healed mucosa in the colon (endoscopic remission) more often than “inflammatory” pseudopolyps, which reflect active inflammation in the colon.