In patients with inflammatory bowel disease, mucosal healing is associated with improved clinical outcomes including prolonged remission, decreased hospitalizations and surgery, and decreased colorectal cancer risk. Objective assessment of endoscopic disease activity and treating to achieve mucosal healing is increasingly being incorporated as an endpoint in clinical trials and as part of standard clinical care. However currently there is no consensus on the definition of mucosal improvement and healing and there are limited validated endoscopic scoring systems available. This chapter discusses the role of endoscopy and mucosal disease activity in prognosticating the disease course and the benefits of achieving mucosal healing in IBD. In addition, we critically analyze the currently available endoscopic scoring systems from the point of view of clinical trials and clinical practice. Finally, we discuss how endoscopy and a “treat-to-target” approach may be utilized in clinical practice.
|Title of host publication||Crohn's Disease and Ulcerative Colitis|
|Subtitle of host publication||From Epidemiology and Immunobiology to a Rational Diagnostic and Therapeutic Approach|
|Editors||Daniel C Baumgart|
|Place of Publication||New York NY USA|
|Pages||267 - 277|
|Number of pages||11|
|Publication status||Published - 2017|