Colonoscopy in surveillance of inflammatory bowel disease

Patients with chronic colitis from inflammatory bowel disease (IBD), whether ulcerative colitis or Crohn’s disease, have an increased risk of colorectal cancer (CRC), which accounts for approximately 10–15% of all deaths among IBD patients. The risk of CRC increases with disease duration and is frequently preceded by the pre-cancerous histological stage called dysplasia. In an attempt to detect dysplasia and asymptomatic cancers in patients with IBD, most national gastroenterology societies recommend initiating colonoscopy surveillance after 8 to 10 years of diagnosis. The goal of surveillance is to reduce the risk of cancer and mortality due to CRC. Current studies of surveillance using chromoendoscopy (dye spray) have demonstrated improved detection of dysplasia compared to conventional colonoscopy surveillance and have changed the approach from random to targeted biopsies. In this article, Saqib Ahmad and Krish Ragunath aim to discuss chromoendoscopy in detail with brief discussion about management of ...