THE ROLE OF A COLONOSCOPY IN INFLAMMATORY BOWEL DISEASE (IBD)

Abstract

BACKGROUND Gastrointestinal endoscopy provides details of the surface of the gastrointestinal tract, whichhas made it possible to examine it. Despite significant advances in our understanding andtreatment of inflammatory bowel disease, the role of gastrointestinal endoscopy in diagnosis, surveillance and therapy of inflammatory bowel disease patients is still controversal.Of course, endoscopy plays a key role in the management of inflammatory bowel disease.Indication for endoscopy in patients with inflammatory bowel disease are diverse andcommonly prompted by acute events on the need for colorectal cancer screening. Howeverdyscomfort, potential risks and costs associated to endoscopic examination should contribute to the narrowing of indication to those cases in which the results of endoscopy isessential to determine a variation in the management strategy. In this article author provides a critical review of the value and yield of an endoscopy in various clinical scenarioswhere an endoscopy is commonly entertained in patients with inflammatory boweldisease. Colonoscopy has a prognostic role during severe flare of inflammatory boweldisease, both in ulcerative colitis and Chron’s disease; moreover in Crohn’s disease theevaluation of recurrent lesions after curative treatment has a strong prognostic role. CONCLUSIONS The author emphasizes that an endoscopy should not routinely be used to evaluate diseaseactivity in patients who are doing well and are in remission. The article provides 10valuable tips about how to integrate an endoscopy into the management of patients withinflammatory bowel disease and reviews the role endoscopy plays in patient with bloodydiarrhea, distinguishing Crohn’s disease from ulcerative colitis at an endoscopy, in patientwith chronic nonbloody diarrhea and cancer surveillance in patients with inflammatorybowel disease