ASGE Annual Postgraduate Course Endoscopy 2022: Breakthrough to Excellence

Farraye ASGE Interpretation IBD

Pdf Summary

In this document, Dr. Francis Farraye discusses the identification and interpretation of mucosal disease activity and dysplasia in inflammatory bowel disease (IBD) using endoscopy. The document includes information from a study by Shergill et al. that emphasizes the importance of using histology in distinguishing IBD from other conditions and highlights the role of endoscopy in assessing disease activity and response to treatment.<br /><br />The document also emphasizes the need for standardized documentation of endoscopic findings, including descriptors such as the extent of disease, presence of specific features like erythema and ulcers, and involvement of the terminal ileum. It recommends classifying IBD phenotypes according to validated systems such as the Montreal classification, which describes disease extent in both ulcerative colitis (UC) and Crohn's disease.<br /><br />The document introduces scoring systems for assessing disease activity in UC, such as the Mayo endoscopic score, and provides explanations of the scoring criteria. It also mentions other scoring systems such as SES-CD and Rutgeerts scores.<br /><br />The document discusses the identification and management of dysplasia in IBD, noting that most dysplasia in the colon can be visualized using HD white-light colonoscopy or image-enhanced endoscopy. It suggests using a modified Paris Classification to describe colorectal lesions in IBD and highlights the importance of targeted biopsy sampling for dysplasia surveillance.<br /><br />The document mentions the use of artificial intelligence (AI) technology in assessing disease activity endoscopically and histologically and in detecting dysplasia in patients with IBD. It suggests that AI platforms may help characterize disease severity and identify dysplasia in the future.<br /><br />In conclusion, the document emphasizes the importance of using endoscopic scoring systems, describing lesions found on colonoscopy in detail, and using advanced techniques like chromoendoscopy to aid in the assessment and management of IBD and dysplasia.

Keywords

mucosal disease activity

dysplasia

inflammatory bowel disease

endoscopy

histology

distinguishing IBD

disease extent

Montreal classification

Mayo endoscopic score

artificial intelligence