Endoscopy remains an essential modality for the diagnosis, risk stratification, monitoring, and therapy of inflammatory bowel disease (IBD). Recent advances, including high-definition imaging, dye-based and virtual chromoendoscopy, and AI-assisted interpretation, improve dysplasia detection and grading of inflammatory activity, enabling treat-to-target care. In Crohn's disease, small-bowel and pan-enteric capsule endoscopy expand noninvasive assessment, while device-assisted enteroscopy allows targeted biopsy and therapy when tissue or intervention is required. Standardized scoring systems (MES/UCEIS, SES-CD, Rutgeerts) support objective follow-up, including early postoperative evaluation. Therapeutically, endoscopic balloon dilation for short strictures and advanced resection techniques (EMR/ESD) for visible dysplasia in experienced centers provide organ-sparing options; endoscopic fistula closure remains investigational. This review synthesizes contemporary trials and ECCO, ESGE, and ASGE guidance into practical algorithms that promote precise surveillance and timely intervention, positioning endoscopy as a functional, predictive, and increasingly personalized tool in IBD care
Roseira, J., Manuela Estevinho, M., Gros, B., Marafini, I., Solitano, V., Sousa, P., et al. (2025). Advances in endoscopy in IBD diagnostics and management. BAILLIERE'S BEST PRACTICE & RESEARCH. CLINICAL GASTROENTEROLOGY, 78, 1-19 [10.1016/j.bpg.2025.102055].
Advances in endoscopy in IBD diagnostics and management
Irene Marafini;
2025-01-01
Abstract
Endoscopy remains an essential modality for the diagnosis, risk stratification, monitoring, and therapy of inflammatory bowel disease (IBD). Recent advances, including high-definition imaging, dye-based and virtual chromoendoscopy, and AI-assisted interpretation, improve dysplasia detection and grading of inflammatory activity, enabling treat-to-target care. In Crohn's disease, small-bowel and pan-enteric capsule endoscopy expand noninvasive assessment, while device-assisted enteroscopy allows targeted biopsy and therapy when tissue or intervention is required. Standardized scoring systems (MES/UCEIS, SES-CD, Rutgeerts) support objective follow-up, including early postoperative evaluation. Therapeutically, endoscopic balloon dilation for short strictures and advanced resection techniques (EMR/ESD) for visible dysplasia in experienced centers provide organ-sparing options; endoscopic fistula closure remains investigational. This review synthesizes contemporary trials and ECCO, ESGE, and ASGE guidance into practical algorithms that promote precise surveillance and timely intervention, positioning endoscopy as a functional, predictive, and increasingly personalized tool in IBD careI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
