Associate Editor Lisa Strate, MD, MPH recommends this article from the August issue: “Assessment of mucosal healing in inflammatory bowel disease: review” by Parambir S. Dulai, MBBS, Barrett G. Levesque, MD, MS, Brian G. Feagan, MD, Geert D’Haens, MD, PhD, and William J. Sandborn, MD.
Mucosal healing has been shown to correlate with treatment outcomes in randomized trials of inflammatory bowel disease (IBD), but it is less clear how to incorporate this treatment measure into clinical practice. The literature on this topic is increasing and it can be difficult for clinicians, especially those who do not specialize in IBD, to encorporate new developments into practice. This paper reviews the importance of assessing mucosal healing in the management of inflammatory bowel disease and summarizes available scoring systems and diagnostic modalities for assessing mucosal healing. The performance characteristics, advantages and disadvantages of colonoscopy, histopathology, magnetic resonance enterography (MRE), video capsule endoscpy and device assisted enteroscopy are reviewed. Clear, concise tables and an algorithmic approach are provided.
I recommend this article because it distills a complicated and expanding topic into a practical and concise guide for clinicians.
Mucosal healing is an important treatment outcome for patients with IBD. Currently, ileocolonoscopy plus MRE for small bowel disease is the preferred initial approach. Endoscopy-based scoring indices can be used to systematically assess and follow mucosal healing.
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