Colonoscopy in inflammatory bowel disease is not only for assessing activity. In long-standing ulcerative colitis or Crohn colitis involving the colon, surveillance for dysplasia and early cancer is also important.
Intervals are not identical for every patient. Disease duration and extent, cumulative inflammatory burden, family history, prior dysplasia and primary sclerosing cholangitis are considered together.
With modern high-definition colonoscopy, visible lesions should be carefully characterised. Selected lesions may be removed by EMR or ESD, while borders, fibrosis, multifocality and the possibility of invisible dysplasia influence management.
IBD-associated dysplasia is therefore best managed through collaboration between gastroenterology, advanced endoscopy, pathology and surgery when needed.
Intervals are not identical for every patient. Disease duration and extent, cumulative inflammatory burden, family history, prior dysplasia and primary sclerosing cholangitis are considered together.
With modern high-definition colonoscopy, visible lesions should be carefully characterised. Selected lesions may be removed by EMR or ESD, while borders, fibrosis, multifocality and the possibility of invisible dysplasia influence management.
IBD-associated dysplasia is therefore best managed through collaboration between gastroenterology, advanced endoscopy, pathology and surgery when needed.