Abstract
Nowadays, the relevance of the endoscopic activity of ulcerative colitis (UC) has been translated into the new concept of “mucosal healing (MH)” as the therapeutic goal to achieve, because considerable scientific evidence indicated the favorable prognostic value of a healed mucosa in clinical outcome of UC. In this regard, MH assessed by endoscopy seems almost like the “gold standard” for evaluating UC activity. On the other hand, we should recognize that there were no prospectively validated endoscopic scoring systems of UC activity in previous clinical trials. In the future, development of new endoscopic scoring systems, which are prospectively validated, will standardize the definition of MH. In addition, recent interest on mucosal healing skews toward not only endoscopic remission but also histological improvement (so-called histological MH). To be precise, histological MH can be an ideal goal for treatment of UC. However, it seems to be more difficult to decide the exact definition of histological MH than that of endoscopic MH. New endoscopic techniques, “confocal endomicroscopy in vivo”, might be promising modalities in the assessment of MH. We should await data concerning the real-time evaluation of MH in UC patients by confocal endomicroscopy. There are many issues to be addressed with regard to standardization of MH, therefore, “The road to justification of MH in the treatment of UC has just started ”.
Published Version
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