Endoscopy in inflammatory bowel disease: Role in diagnosis, management, and treatment

Table 1 Mayo endoscopic subscore

Normal (0): No inflammatory signs

Mild (1): Erythema

Moderate (2): Friability, erosions

Severe (3): Spontaneous bleeding, ulcerations

Four-grade scale (0-3)[22].

Table 2 Simple endoscopic score in Crohn’s disease

Ulcer: None (0), 0.1-0.5 cm (1), 0.5-2 cm (2), > 2 cm (3)

Ulcerated surface: None (0), < 10% (1), 10%-30% (2), > 30% (3)

Affected surface: None (0), < 50% (1), 50%-75% (2), > 75% (3)

Narrowing: None (0), single passable (1), multiple passable (2), impassable (3)

Sum of five segments scores for a total score (0-56)[23].

Table 3 Surveillance for Colorectal Endoscopic Neoplasia Detection and Management in Inflammatory Bowel Disease Patients: International Consensus recommendations for optimizing detection and management of dysplasia in inflammatory bowel disease[28]

Detection of dysplasia on surveillance colonoscopy	When performing surveillance with white-light colonoscopy, high definition is recommended rather than standard definition
	When performing surveillance with standard-definition colonoscopy, chromoendoscopy is recommended rather than white-light colonoscopy
	When performing surveillance with high-definition colonoscopy, chromoendoscopy is suggested rather than white-light colonoscopy
	When performing surveillance with standard-definition colonoscopy, narrow-band imaging is not suggested in place of white-light colonoscopy
	When performing surveillance with high-definition colonoscopy, narrow-band imaging is not suggested in place of white-light colonoscopy
	When performing surveillance with image-enhanced high-definition colonoscopy, narrow-band imaging is not suggested in place of chromoendoscopy
Management of dysplasia discovered on surveillance colonoscopy	After complete removal of endoscopically resectable polypoid dysplastic lesions, surveillance colonoscopy is recommended rather than colectomy
	After complete removal of endoscopically resectable nonpolypoid dysplastic lesions, surveillance colonoscopy is suggested rather than colectomy
	For patients with endoscopically invisible dysplasia (confirmed by a GI pathologist) referral is suggested to an endoscopist with expertise in IBD surveillance using chromoendoscopy with high-definition colonoscopy

IBD: Inflammatory bowel disease.

Table 4 Rutgeerts score for Crohn’s disease recurrence at ileocolonic anastomoses[35]

i0 no lesions in neoterminal ileum

i1 < 5 aphthous lesions in neoterminal ileum

i2 > 5 aphthous lesions with normal mucosa, skip areas with larger lesions, anastomotic lesions

i3 diffuse aphthous ileitis

i4 diffuse inflammation with ulcer, nodules, and/or stenosis