The Contribution of Endoscopy in IBD

Endoscopy plays many important roles in the management of inflammatory bowel diseases (IBDs). It is essential for diagnosis, allowing direct visualization of mucosal inflammation, ulcerations, and strictures, as well as performing biopsies for histological assessment. Beyond diagnosis, endoscopy offers precise delineation of disease extent and activity, which is fundamental for prognostic assessment and the selection or adjustment of medical therapy. During follow-up, it serves as an indispensable tool for tracking disease course and confirming mucosal healing – an increasingly recognized treatment objective linked to favorable long-term outcomes. Surveillance examinations are also critical for the early identification of precancerous changes or carcinoma, especially in individuals with prolonged disease duration or those with coexisting primary sclerosing cholangitis, where enhanced imaging modalities such as chromoendoscopy significantly improve dysplasia detection. In addition, endoscopy facilitates therapeutic procedures, including the dilation of short, accessible strictures and the resection of polypoid or dysplastic lesions, thereby complementing its diagnostic and monitoring roles. Recent advances in digestive endoscopy have enhanced diagnostics by combining real-time imaging with histological analysis, while artificial intelligence now plays a key role in automating and standardizing image analysis.