Endoscopic evaluation in diagnosis and management of inflammatory bowel disease

Core Tip

Core tip: Ileo-colonoscopy remains the most important test in the diagnosis and monitoring of inflammatory bowel disease (IBD). Video capsule endoscopy shows very high sensitivity for small bowel mucosal lesions not accessible to conventional flexible endoscopes. Both techniques facilitate monitoring of response to treatment. Endoscopic activity indices are important for monitoring treatment response and can help identify patients who may benefit from treatment escalation. Colorectal cancer surveillance in patients with IBD is shifting from high frequency random biopsies, to that of high quality visual inspection and targeted biopsies of suspected dysplasia, enabled by technological advances including chromoendoscopy and high-definition endoscopes.