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Review on Advances in Pediatric Endoscopy in the Management of Inflammatory Bowel Disease
Sara Isoldi1,2, Saverio Mallardo2, Paolo Quitadamo1
1Pediatric Gastroenterology and Hepatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy.
Insights
Gastrointestinal endoscopy is crucial for managing pediatric inflammatory bowel diseases (IBD), guiding treatment toward mucosal healing. This review covers various endoscopic techniques and their role in diagnosis, management, and surveillance in children with IBD.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Endoscopy
- Inflammatory Bowel Disease (IBD) Management
Background:
- Gastrointestinal (GI) endoscopy is increasingly vital in pediatric inflammatory bowel diseases (IBD) management.
- Mucosal healing is now the target endpoint in the treat-to-target paradigm for IBD.
- Technological and anesthetic advancements enable comprehensive GI tract evaluation in children.
Purpose of the Study:
- To review the role of various endoscopic procedures in the diagnosis and management of pediatric Crohn's disease (CD) and ulcerative colitis.
- To highlight non-invasive techniques like wireless capsule endoscopy.
- To discuss endoscopic scoring systems, complication management, and cancer surveillance in pediatric IBD.
Main Methods:
- Review of current literature on GI endoscopy in pediatric IBD.
- Discussion of ileocolonoscopy, upper GI endoscopy, and device-assisted enteroscopy.
- Focus on wireless capsule endoscopy, endoscopic scoring systems, and surveillance techniques.
Main Results:
- Endoscopy is essential for evaluating pediatric IBD, including Crohn's disease and ulcerative colitis.
- Various endoscopic tools aid in diagnosis, monitoring disease activity, and assessing treatment response.
- Advanced techniques improve detection and management of complications and dysplasia.
Conclusions:
- Gastrointestinal endoscopy plays a pivotal role in the comprehensive management of pediatric IBD.
- Endoscopic techniques are crucial for achieving mucosal healing, managing complications, and performing cancer surveillance.
- Continued advancements in endoscopy enhance the care of children with IBD.
Abstract:
Over the past decades, an increased importance has been given to gastrointestinal (GI) endoscopy in the management of children with inflammatory bowel diseases (IBD), considering that mucosal healing has been recognized as the optimal endpoint in the treat-to-target paradigm. The recent advances in technology and anesthesia have facilitated the comprehensive evaluation of the GI tract. In this review, we will discuss the role of ileocolonoscopy, upper GI endoscopy, and device-assisted enteroscopy in the work-up and management of pediatric Crohn's disease (CD) and ulcerative colitis, with particular attention on non-invasive endoscopic techniques, such as wireless capsule endoscopy. We will also analyze the most commonly used endoscopic scoring systems, including small bowel scoring systems and endoscopic recurrence grading of neo-terminal ileum CD. Moreover, we will focus on the endoscopic management of complications, such as strictures, that commonly require surgery. Lastly, we will discuss cancer surveillance in children with IBD, with particular consideration of the role of high-definition endoscopic equipment and chromoendoscopy in dysplasia detection rates.
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