Published online May 28, 2021. doi: 10.3748/wjg.v27.i20.2521
Peer-review started: January 22, 2021
First decision: March 29, 2021
Revised: April 11, 2021
Accepted: April 26, 2021
Article in press: April 26, 2021
Published online: May 28, 2021
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.
Core Tip: Endoscopy is critical to the diagnosis of inflammatory bowel diseases (IBD) and is increasingly being used for disease monitoring and management to achieve the therapeutic goal of mucosa healing. In this review, we focus on the utility of endoscopy as a therapeutic objective, in disease monitoring, and in surveillance to detect and prevent neoplasia. We will also discuss the evolving role of endoscopic therapeutic interventions in IBD.