Current role of endoscopy in inflammatory bowel disease diagnosis and management

PURPOSE OF REVIEW: This review will summarize the role of endoscopy in the diagnosis of inflammatory bowel disease (IBD), in assessing its activity, its management, interventional endoscopy, and cancer surveillance. RECENT FINDINGS: Endoscopy in IBD underwent major advances in the recent years, with the emergence of new techniques such as wireless video capsule endoscopy (WCE), device-assisted enteroscopy (DAE), chromoendoscopy, and confocal endomicroscopy. WCE is a minimally invasive tool, enabling the visualization of the entire small bowel mucosa. It has gained a substantial role in the evaluation of patients with suspected Crohn's disease and indeterminate colitis. With the correct use of the International Conference on Capsule Endoscopy criteria, WCE has a high positive predictive value in patients with suspected Crohn's disease. Moreover, WCE has a very high negative predictive value in patients with suspected Crohn's disease. DAE has established its role as a complementary tool in cases where there is need of biopsies or dilatation of strictures. Chromoendoscopy and confocal endomicroscopy are techniques that may assist in cancer surveillance in IBD patients. SUMMARY: Endoscopy has a major role in the diagnosis of IBD, assessing its extent, treating some of its complications, assessing the success of various treatments, and as a predictor of disease course.