4.6 Review

Evolving role of endoscopy in inflammatory bowel disease: Going beyond diagnosis

Journal

WORLD JOURNAL OF GASTROENTEROLOGY
Volume 27, Issue 20, Pages 2521-2530

Publisher

BAISHIDENG PUBLISHING GROUP INC
DOI: 10.3748/wjg.v27.i20.2521

Keywords

Inflammatory bowel disease; Endoscopy; Crohn's disease; Ulcerative colitis; Therapeutic endoscopy; Surveillance

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Endoscopic evaluation plays a crucial role in predicting disease activity and severity in inflammatory bowel diseases, with mucosal healing associated with improved clinical outcomes and incorporated into standard care. Therapeutic endoscopic options and surveillance strategies, including early detection of neoplasia, continue to advance with evolving technology and visualization techniques.
YYYY Inflammatory bowel disease, encompassing Crohn's disease (CD) and ulcerative colitis, are chronic immune-mediated inflammatory bowel diseases (IBD) that primarily affect the gastrointestinal tract with periods of activity and remission. Large body of evidence exist to strengthen the prognostic role of endoscopic evaluation for both disease activity and severity and it remains the gold standard for the assessment of mucosal healing. Mucosal healing has been associated with improved clinical outcomes with prolonged remission, decreased hospitalization, IBD-related surgeries and colorectal cancer risk. Therefore, endoscopic objectives in IBD have been incorporated as part of standard care. With the known increased risk of colorectal cancer in IBD, although prevention strategies continue to develop, regular surveillance for early detection of neoplasia continue to be paramount in IBD patients' care. It is thanks to evolving technology and visualization techniques that surveillance strategies are continuously advancing. Therapeutic endoscopic options in IBD have also been expanding, from surgery sparing therapies such as balloon dilation of fibrostenotic strictures in CD to endoscopic mucosal resection of neoplastic lesions. In this review article, we discuss the current evidence on the use of endoscopy as part of standard of care of IBD, its role in surveillance of neoplasia, and the role of interventional endoscopic therapies.

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