How Do We Treat Inflammatory Bowel Diseases to Aim For Endoscopic Remission?

Parambir S. Dulai*, Vipul Jairath

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations

Abstract

Crohn's disease and ulcerative colitis are heterogeneous conditions which may manifest with 1 or more of a constellation of abnormal symptoms, elevated biomarkers, and/or objective evidence of inflammation on endoscopic or cross-sectional evaluation. Whilst resolution of symptoms and restoration of quality of life is the primary goal for patients following a disease flare, there may be discordance between resolution of symptoms, biomarkers, and endoscopy. Increased emphasis is placed on the achievement of endoscopic remission, given it is associated with improved outcomes and reduction in hospitalization and surgeries. As the therapeutic armamentarium for inflammatory bowel disease does not achieve remission in all patients, there is greater emphasis on repetitive interval-based assessment of disease activity with sequential algorithmic treatment adjustments until endoscopic remission is achieved, in a so-called treat-to-target approach. We review the role of symptoms, biomarkers, imaging and endoscopy within treat-to-target algorithms and provide a practical guidance to their use in clinical practice.

Original languageEnglish (US)
Pages (from-to)1300-1308
Number of pages9
JournalClinical Gastroenterology and Hepatology
Volume18
Issue number6
DOIs
StatePublished - May 2020
Externally publishedYes

Keywords

  • Biomarkers
  • Crohn's Disease
  • Disease Monitoring
  • Outcomes
  • Prediction
  • Ulcerative Colitis

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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