The Role of Narrowed Spectrum Technologies and Dye-based Endoscopy in Inflammatory Bowel Disease: New Advances and Opportunities

Endoscopic assessment of inflammation and mucosal healing is an important tool for the appropriate management of patients with inflammatory bowel diseases (IBD). The current definition of mucosal healing using standard white-light endoscopy is being challenged because often histological activity which by itself correlates with clinical outcomes, is being observed. New endoscopic techniques using optical and digital enhancement have highlighted fine details of mucosal and vascular patterns, reflecting better histological changes in the inflammation and healing processes. These technologies can also define colonic lesions in IBD. As the method of choice, recommended by the Surveillance for Colorectal Endoscopic Neoplasia Detection and Management in Inflammatory Bowel Disease Patients: International Consensus Recommendations (SCENIC), was dye chromoendoscopy with targeted biopsies, recent studies have demonstrated similar efficacy of high definition endoscopy and virtual chromoendoscopy for dysplasia detection in IBD. Furthermore, these techniques can help characterize endoscopic resectability of lesions, a term the SCENIC consensus has introduced, thereby help in colon preservation in selected cases. Finally, as in other fields in Gastrointestinal endoscopy, neural networks for computer aided diagnosis and endoscopic pattern recognition is being introduced in the field of IBD, and are the new future at the horizon in assessing accurately disease activity and colonic lesions, to support decision making processes. This review will present the use of advanced endoscopic techniques in the assessment and management of IBD.