Gastrointestinal luminal endoscopy is of paramount importance for diagnosis, monitoring and dysplasia surveillance in patients with both, Crohn’s disease and ulcerative colitis. Moreover, with the recent recognition that mucosal healing is directly linked to the clinical outcome of patients with inflammatory bowel disorders, a growing demand exists for the precise, timely and detailed endoscopic assessment of superficial mucosal layer. Further, the novel field of molecular imaging has tremendously expanded the clinical utility and applications of modern endoscopy, now encompassing not only diagnosis, surveillance, and treatment but also the prediction of individual therapeutic responses. Within this review, we describe how novel endoscopic approaches and advanced endoscopic imaging methods such as high definition and high magnification endoscopy, dye-based and dye-less chromoendoscopy, confocal laser endomicroscopy, endocytoscopy and molecular imaging now allow for the precise and ultrastructural assessment of mucosal inflammation and describe the potential of these techniques for dysplasia detection.

• Ulcerative colitis
• Crohn’s disease
• Advanced endoscopic imaging
• Chromoendoscopy
• Mucosal healing
• Colitis associated cancer
• Confocal laser endomicroscopy
• Endocytoscopy
• Molecular imaging

• Chromogenic Compounds
• Colitis, Ulcerative/diagnostic imaging
• Colitis, Ulcerative/pathology
• Crohn Disease/diagnostic imaging
• Crohn Disease/pathology
• Endoscopy, Gastrointestinal/methods
• Humans
• Intestines/diagnostic imaging
• Intestines/pathology
• Microscopy, Confocal
• Molecular Imaging/methods
• Predictive Value of Tests
• Prognosis

Inflammatory bowel diseases (IBD) comprise the two major entities Crohn’s disease and ulcerative colitis and endoscopic imaging of the gastrointestinal tract has always been an integral and central part in the management of IBD patients. Within the recent years, mucosal healing emerged as a key treatment goal in IBD that substantially decides about the clinical outcome of IBD patients, thereby demanding for a precise, timely and detailed endoscopic assessment of the mucosal inflammation associated with IBD. Further, molecular imaging has tremendously expanded the clinical utility and applications of modern endoscopy, now encompassing not only diagnosis, surveillance, and treatment but also the prediction of individual therapy response. Within this review we describe novel endoscopic approaches and advanced endoscopic imaging methods for the diagnosis, treatment and surveillance of IBD patients. We begin by providing an overview over novel and advanced imaging techniques such as magnification endoscopy and dye-based and dye-less chromoendoscopy, endomicroscopy and endocytoscopy. We then describe how these techniques can be utilized for the precise and ultrastructural assessment of mucosal inflammation and dysplasia development associated with IBD and outline how they have enabled the endoscopist to gain insight onto the cellular level in real-time. Finally, we provide an outlook on how molecular imaging has rapidly evolved in the recent past and can be used to make individual predictions about the therapeutic response towards biological treatment.

• Gastrointestinal endoscopy
• Crohn’s disease
• Ulcerative colitis
• Inflammatory bowel diseases
• Colon
• Colorectal neoplasms

• Chromogenic Compounds/administration & dosage
• Colitis, Ulcerative/pathology
• Crohn Disease/pathology
• Endoscopy, Gastrointestinal/methods
• Epithelial Cells/pathology
• Humans
• Image Enhancement
• Intestinal Mucosa/pathology
• Microscopy, Confocal
• Molecular Imaging
• Predictive Value of Tests