The Key Roles of Endoscopy in Inflammatory Bowel Disease

Charles J. Lightdale, MD, Consulting Editor

New scientific insights into the pathogenesis of inflammation and autoimmune diseases, including inflammatory bowel disease, have led to a new era in the management of Crohn disease and ulcerative colitis. These discoveries have enabled better application of older anti-inflammatory agents and immunomodulators, and of course, have resulted in the introduction of novel biological agents, starting with infliximab, the monoclonal antibody to tumor necrosis factor-α. Multiple biological agents are now available to gastroenterologists treating inflammatory bowel disease, and many more are in the pharmaceutical development pipeline. At the same time, there is increasing evidence of the effects of the gut microbiome on the bowel mucosa in inflammatory bowel disease, and new treatments have emerged in an effort to modify the bacterial environment.

Remarkably, the roles of endoscopy have actually increased in this new era in management of Crohn disease and ulcerative colitis. At the same time, the demands on the endoscopist have significantly expanded for more careful systematic inspection and classification, and for proper application of advanced imaging, endoscopic biopsy, resection, and stricture dilation. It seemed clear to me that a new issue of the Gastrointestinal Endoscopy Clinics of North America on the subject of “Endoscopy in Inflammatory Bowel Disease” was needed. Dr Maria Abreu, an astute and thoughtful clinician and researcher, and a valued and prominent leader in the field, is the guest editor for this issue. She has chosen a truly comprehensive list of topics covering the multiple ways that endoscopy can assist in management of patients with inflammatory bowel disease and has gathered an extraordinary group of expert authors. There is much to be learned, and I strongly urge gastroenterologists and colorectal surgeons to read this issue in its entirety. This is critical reading for you and will ensure that you are up-to-date in applying endoscopy correctly for the benefit of your patients in the current time and into the future.

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