Endoscopic Disease Activity in Inflammatory Bowel Disease.

Endoscopic scoring systems in Crohn's disease and ulcerative colitis aim to translate the assessment of mucosal disease activity into a quantified value. This value seeks to provide a clear, objective record of the endoscopic mucosal severity, which can then be used to guide medical management decisions. The primary driver of all endoscopic indices, however, is to define a scale of responsiveness for therapeutic endpoints in clinical trials. Mucosal healing now has widespread acceptance as a therapeutic and clinical endpoint, but despite the development of multiple endoscopic scoring systems, the endoscopic definition has yet to be resolved. This review describes recent advances in endoscopic scoring systems for ulcerative colitis (Mayo Clinic endoscopy subscore, UCEIS, and UCCIS among others) and for Crohn's disease.

Electronic imaging to enhance lesion detection at colonoscopy.

Adenoma removal prevents colorectal cancer (CRC) development. Lower adenoma detection rates correlate with increased postcolonoscopy CRC. Chromoendoscopy it is not practical for routine use. It was hoped that electronic imaging techniques would offer effective alternatives to improve detection; however, meta-analyses in average-risk patients indicate no benefit. Narrow band imaging may be of benefit for high-risk surveillance. Combining electronic imaging techniques with molecular imaging probes may highlight dysplasia at a molecular level. In future colonoscopy is likely to rely on sensitive and specific, labeled molecular probes detected by electronic endoscopic imaging to enhance detection and reduce miss rates for premalignant lesions.