Endoscopy in Inflammatory Bowel Disease: Asian Perspectives with Respect to Japan

Abstract

Endoscopy has an important role in the management of gastrointestinal tract disease in Japan. Mucosal healing is a new goal of the management of inflammatory bowel disease (IBD). This has expanded the use of endoscopy. This chapter presents a review of the use of endoscopy for IBD in Japan. Surveillance colonoscopy with target biopsy for long-standing ulcerative colitis (UC) is advocated. A consensus statement has been developed for the diagnosis and management of intestinal Behcet’s disease (BD) in Japan, and adalimumab has been approved to treat BD based on the findings of a Japanese multicenter study. A patency capsule that does not have a radioactive tag has been developed for capsule endoscopy (CE). CE can also be used as an alternative to traditional endoscopy to identify small intestinal lesions in patients with UC. Balloon-assisted endoscopy (BAE) is the gold standard for small intestinal lesions, and is more sensitive than magnetic resonance (MR) imaging for detecting intestinal damage. Endoscopic balloon dilation for the removal of foreign bodies, including retained capsule endoscope, is also important. Endocytoscopy is a developing technology to assess inflammation, and endocytoscopic narrow band imaging is useful for evaluating the severity of UC.