Crohn’s disease(CD)and ulcerative colitis(UC)constitute the twomost common phenotypes of inflammatory bowel disease(IBD).Ileocolonoscopy with biopsy has been considered the gold standard for the diagnosis of IBD.Diff...Crohn’s disease(CD)and ulcerative colitis(UC)constitute the twomost common phenotypes of inflammatory bowel disease(IBD).Ileocolonoscopy with biopsy has been considered the gold standard for the diagnosis of IBD.Differential diagnosis of CD and UC is important,as theirmedical and surgical treatmentmodalities and prognoses can be different.However,approximately 15%of patients with IBD aremisdiagnosed as IBD unclassified due to the lack of diagnostic certainty of CD or UC.Recently,there has been increased recognition of the role of the therapeutic endoscopist in the field of IBD.Newer imaging techniques have been developed to aid in the differentiation of UC vs CD.Furthermore,endoscopic balloon dilation and stenting have become an integral part of the therapeutic armamentariumof CD stricturemanagement.Endoscopic ultrasound has been recognized as beingmore accurate thanmagnetic resonance imaging in detecting perianal fistulae in patientswith CD.Additionally,chromoendoscopymay help to detect dysplasia earlier compared with white-light colonoscopy.Hence,interventional endoscopy has become a cornerstone in the diagnosis,treatment andmanagement of IBD complications.The role of endoscopy in the field of IBD has significantly evolved in recent years fromsmall-bowel imaging to endoscopic balloon dilation and use of chormoendoscopy in dysplasia surveillance.In this reviewarticle,we discuss the current evidence on interventional endoscopy in the diagnosis,treatment andmanagement of IBD compications.展开更多
文摘Crohn’s disease(CD)and ulcerative colitis(UC)constitute the twomost common phenotypes of inflammatory bowel disease(IBD).Ileocolonoscopy with biopsy has been considered the gold standard for the diagnosis of IBD.Differential diagnosis of CD and UC is important,as theirmedical and surgical treatmentmodalities and prognoses can be different.However,approximately 15%of patients with IBD aremisdiagnosed as IBD unclassified due to the lack of diagnostic certainty of CD or UC.Recently,there has been increased recognition of the role of the therapeutic endoscopist in the field of IBD.Newer imaging techniques have been developed to aid in the differentiation of UC vs CD.Furthermore,endoscopic balloon dilation and stenting have become an integral part of the therapeutic armamentariumof CD stricturemanagement.Endoscopic ultrasound has been recognized as beingmore accurate thanmagnetic resonance imaging in detecting perianal fistulae in patientswith CD.Additionally,chromoendoscopymay help to detect dysplasia earlier compared with white-light colonoscopy.Hence,interventional endoscopy has become a cornerstone in the diagnosis,treatment andmanagement of IBD complications.The role of endoscopy in the field of IBD has significantly evolved in recent years fromsmall-bowel imaging to endoscopic balloon dilation and use of chormoendoscopy in dysplasia surveillance.In this reviewarticle,we discuss the current evidence on interventional endoscopy in the diagnosis,treatment andmanagement of IBD compications.
