Track 21: Endoscopy in Inflammatory Bowel Disease (IBD)

Endoscopy in Inflammatory Bowel Disease (IBD)

Introduction

Endoscopy plays a pivotal role in the diagnosis, assessment, and long-term management of Inflammatory Bowel Disease (IBD), including Crohn’s disease and Ulcerative colitis. It enables direct visualization of the gastrointestinal mucosa, accurate disease characterization, targeted biopsies, and real-time therapeutic interventions. With continuous advancements, endoscopy has become central to achieving early diagnosis, mucosal healing, disease monitoring, and colorectal cancer surveillance in IBD patients.

Benefits of Endoscopy in IBD

• Accurate Diagnosis: Differentiates IBD from infectious, ischemic, or functional bowel disorders

• Assessment of Disease Extent & Severity: Guides treatment decisions and prognosis

• Monitoring Treatment Response: Evaluates mucosal healing and remission

• Targeted Biopsy Sampling: Confirms histological diagnosis and dysplasia detection

• Early Detection of Complications: Identifies strictures, fistulas, and neoplasia

• Therapeutic Capability: Enables dilation, hemostasis, and lesion resection

• Cancer Surveillance: Reduces colorectal cancer risk through regular monitoring

Types of Endoscopy Used in IBD

1. Colonoscopy

   • Gold standard for diagnosis and surveillance

   • Allows assessment of disease activity and biopsy sampling

2. Flexible Sigmoidoscopy

   • Useful in acute severe colitis and follow-up evaluations

3. Upper GI Endoscopy (EGD)

   • Evaluates upper GI involvement, especially in Crohn’s disease

4. Capsule Endoscopy

   • Detects small bowel involvement not seen on conventional endoscopy

5. Balloon-Assisted Enteroscopy

   • Enables deep small bowel evaluation and therapeutic interventions

6. Chromoendoscopy

   • Enhances detection of dysplasia and early cancer in long-standing IBD

7. Endoscopic Ultrasound (EUS)

   • Assesses perianal disease, abscesses, and fistulas

Conclusion

Endoscopy remains the cornerstone in the comprehensive management of IBD. From initial diagnosis and disease stratification to treatment monitoring and cancer prevention, it offers unmatched diagnostic accuracy and therapeutic potential. The integration of advanced imaging techniques and AI-driven tools continues to improve outcomes, enabling a personalized and proactive approach to IBD care. As endoscopic technology evolves, its role in optimizing patient quality of life and long-term disease control will only expand.