ABSTRACT
This chapter reviews the characteristic endoscopic and radiologic findings of patients with ulcerative colitis (UC) and Crohn’s disease (CD) and provides recommendations on the best diagnostic approach based on disease type and clinical scenario. Ileocolonoscopy with biopsies is the reference imaging method to establish diagnosis, evaluate disease extent and activity in UC. Colonoscopy is the reference standard for the evaluation and quantification of disease activity and extent in patients with UC. For unknown reasons in long-standing UC, there is a characteristic hypertrophy of the muscularis mucosa, which produces a typical tubular shape of the lumen. In contrast to the paediatric inflammatory bowel disease population where upper gastro intestinal endoscopy is mandatory, there are no specific recommendations whether it should be routinely performed in asymptomatic adults. Repeated endoscopy in CD is performed using similar indications as in UC and, additionally, to evaluate post-operative disease recurrence.
