United European Gastroenterol J. 2022 Dec;10(10):1103-1112.doi: 10.1002/ueg2.12316. Epub 2022 Oct 12.

Olga Maria Nardone ^1 2, Rosanna Cannatelli ^1 3, Subrata Ghosh ⁴, Marietta Iacucci ^1 5

Author information

¹Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.

²Department of Public Health, University Federico II of Naples, Naples, Italy.

³Gastroenterology Unit, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, 'Luigi Sacco' University Hospital, Milan, Italy.

⁴APC Microbiome Ireland Centre, College of Medicine and Health, University College Cork, Cork, Ireland.

⁵NIHR Birmingham Biomedical Research Centre, University Hospitals NHS Foundation Trust, University of Birmingham, Birmingham, UK.

Abstract

Endoscopic remission is now considered the ultimate long-term goal for treating inflammatory bowel disease (IBD). Recent advances in endoscopic techniques have progressively added new tools to the armamentarium of endoscopists for a deeper assessment and characterisation of the intestinal mucosa. Virtual Electronic chromoendoscopy is widely available in the endoscopic units, leading to a more accurate evaluation of the vascular and mucosal architecture of the colon, reducing the gap with histology, which is considered a favourable long-term measure. In addition, advanced, sophisticated techniques such as endocytoscope and confocal laser endomicroscopy provide insights into individualised and personalised IBD therapy. Finally, high expectations are placed on the advent of Artificial Intelligence (AI) with promising applications that have the potential to revolutionise IBD diagnosis and management. Here, we discuss state-of-the-art of endoscopic techniques and their applicability to accurate assess endoscopic and histological remission, predict response to therapy and detect, characterise and guide treatment of colonic dysplastic lesions. We are seeing the dawn of a new era wherein the applications of these new endoscopic tools, hand in hand with AI, offer the most incredible opportunity to deliver precision medicine to patients with IBD.