ENDOSCOPIC EVALUATION OF INFLAMMATORY BOWEL DISEASE. WHAT TO USE, WHEN TO USE?
Abstract:
Inflammatory bowel disease (IBD) is a chronic affliction that requires careful regular monitoring and focused treatment, defined by remissions and flares, with frequent hospital admissions, surgical procedures in complicated cases and progression towards dysplasia in longstanding disease. The patient’s quality of life is considerably affected by the disease per se but also by the frequent follow-ups and invasive procedures used for disease activity monitoring. The diagnosis of inflammatory bowel disease rests on symptoms, clinical signs, laboratory and imaging tests and is confirmed by bioptic endoscopy with subsequent pathology examination. Endoscopy is an important tool not just for disease diagnosis but also for disease progression monitoring, early dysplastic lesions diagnosis and therapeutic intervention. Endoscopy offers a fast and straightforward evaluation of the colonic mucosa, enabling the description of the extent and severity of the intestinal lesions leading to the prediction of the disease’s aggressive nature and the introduction of appropriate treatment. The ultimate goal when dealing with IBDs is to reach mucosal healing, thus ensuring a significant improvement of the quality of life and prognosis and a drop in hospitalization expenses and in the need for surgical measures. This paper aims to review the latest Gastrointestinal Endoscopy Society standards of practice guidelines so as to offer a useful algorithm for the use of endoscopy in patient care.
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