Endoscopy in inflammatory bowel disease: Role in diagnosis, management, and treatment

Abstract

Endoscopy plays a fundamental role in the diagnosis, management, and treatment of inflammatory bowel disease (IBD). Colonoscopy, flexible sigmoidoscopy, and esophagogastroduodenoscopy have long been used in the care of patients with IBD. As endoscopic technologies have progressed, tools such as endoscopic ultrasound, capsule endoscopy, and balloon-assisted enteroscopy have expanded the role of endoscopy in IBD. Furthermore, chromoendoscopy has enhanced our ability to detect dysplasia in IBD. In this review article, we will focus on the roles, indications, and limitations of these tools in IBD. We will also discuss the most commonly used endoscopic scoring systems, as well as special considerations in post-surgical patients. Lastly, we will discuss the role of endoscopy in the diagnosis and management of fistulae and strictures.

Keywords: Endoscopy; Inflammatory bowel disease; Crohn’s disease; Ulcerative colitis; Colonoscopy; Capsule endoscopy; Dysplasia detection; Stricture dilation; Fistula management

Core tip: Although endoscopy has long been used in the diagnosis and management of inflammatory bowel disease (IBD), technologic advances have allowed for additional tools to assist in the management and treatment of IBD patients. This review article discusses the roles, indications, and limitations of endoscopy in IBD.