Current role of endoscopy in inflammatory bowel disease diagnosis and management

This review will summarize the role of endoscopy in the diagnosis of inflammatory bowel disease (IBD), in assessing its activity, its management, interventional endoscopy, and cancer surveillance.

Endoscopy in IBD underwent major advances in the recent years, with the emergence of new techniques such as wireless video capsule endoscopy (WCE), device-assisted enteroscopy (DAE), chromoendoscopy, and confocal endomicroscopy. WCE is a minimally invasive tool, enabling the visualization of the entire small bowel mucosa. It has gained a substantial role in the evaluation of patients with suspected Crohn's disease and indeterminate colitis. With the correct use of the International Conference on Capsule Endoscopy criteria, WCE has a high positive predictive value in patients with suspected Crohn's disease. Moreover, WCE has a very high negative predictive value in patients with suspected Crohn's disease. DAE has established its role as a complementary tool in cases where there is need of biopsies or dilatation of strictures. Chromoendoscopy and confocal endomicroscopy are techniques that may assist in cancer surveillance in IBD patients.

Endoscopy has a major role in the diagnosis of IBD, assessing its extent, treating some of its complications, assessing the success of various treatments, and as a predictor of disease course.