Endoscopic scores for inflammatory bowel disease in the era of ‘mucosal healing’: Old problem, new perspectives

• Published in: Digestive and liver disease Vol. 48; no. 7; pp. 703 - 708
• Main Authors: Pagnini, Cristiano, Menasci, Francesca, Desideri, Federico, Corleto, Vito D., Delle Fave, Gianfranco, Di Giulio, Emilio
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.07.2016
• Subjects: Crohn's disease; Endoscopic score; Endoscopy, Gastrointestinal; Gastroenterology and Hepatology; Humans; Inflammatory bowel disease; Inflammatory Bowel Diseases - diagnosis; Inflammatory Bowel Diseases - pathology; Intestinal Mucosa - pathology; Mucosal healing; Severity of Illness Index; Ulcerative colitis; Inflammatory bowel disease; Crohn's disease; Mucosal healing; Endoscopic score; Ulcerative colitis; endoscopic score; ulcerative colitis; inflammatory bowel disease; mucosal healing
• ISSN: 1590-8658; 1878-3562
• DOI: 10.1016/j.dld.2016.03.006

The importance of the endoscopic evaluation in inflammatory bowel disease (IBD) management has been recognized for many years. However, the modalities for reporting endoscopic activity represent an ongoing challenge. To address this, several endoscopic scores have been proposed. Very few have been properly validated, and the use of such tools remains sub-optimal and is mainly restricted to clinical trials. In recent years, a growing emphasis of the concept of ‘mucosal healing’ as a prognostic marker and therapeutic goal has increased the need for a more accurate definition of endoscopic activity in both ulcerative colitis (UC) and Crohn's Disease (CD). In the present review, the evolution of the challenges related to endoscopic scores in IBD has been analyzed, with particular attention paid to the renewed relevance of endoscopic activity in recent years. Currently, despite the growing relevance of endoscopic activity, evaluating this activity in IBD is still a challenge. The implementation of efficacious endoscopic scores and a better definition of the absence of activity (mucosal healing) are needed.