The Utility of Endoscopy in Inflammatory Bowel Disease

Abstract

Endoscopy has become an indispensable tool in the diagnosis, classification, and management of inflammatory bowel disease (IBD). Modern developments in endoscopic evaluations and therapy in IBD like small bowel capsule endoscopy, confocal laser endomicroscopy, and small bowel enteroscopy have revolutionized the management of IBD. These advancements have reduced the need for more invasive modalities like surgical procedures and excessive biopsies. They have also greatly improved the diagnostic accuracy for IBD endoscopy and provided gastroenterologists the ability to evaluate the gastrointestinal tract in its entirety. This article reviews screening guidelines, typical endoscopic findings, postoperative endoscopic evaluations, specialized endoscopic evaluations (like small bowel capsule endoscopy, confocal laser endomicroscopy, and endoscopic retrograde cholangiopancreatography), and therapeutic endoscopy in IBD (like endoscopic stricture dilatation, endoscopic drug delivery, stent placement, and fecal microbiota transplant). Different scoring systems like the Montreal classification for Crohn’s disease and ulcerative colitis and the Mayo classification for ulcerative colitis are also discussed.