Setup and principle of endoscopy in inflammatory bowel disease

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Introduction

Endoscopy with histology plays a major role in the diagnosis, disease monitoring, assessment of treatment response, and neoplasia surveillance in inflammatory bowel disease (IBD). Fortunately, any part of diseased gastrointestinal (GI) tract is accessible to various modalities of endoscopy. In addition, various therapeutic modalities can be delivered through the endoscopy. Colonoscopy with ileoscopy and esophagogastroduodenoscopy (EGD) are the two most commonly used diagnostic tools in IBD, along with capsule endoscopy, enteroscopy, and pouchoscopy. Endoscopy is accurate in grading the degree of mucosal inflammation, which has been considered the gold standard for the quantification of the severity of mucosal inflammation in IBD. Certain endoscopic features, such as the distribution of inflammation and characteristics of ulcer, may help differential diagnosis between different phenotypes of IBD and between IBD and non-IBD conditions.