The role of endoscopy in the detection of dysplasia in inflammatory bowel disease

Inflammatory bowel disease (IBD) encompasses a group of chronic inflammatory disorders of the gastrointestinal tract, notably ulcerative colitis (UC) and Crohn’s disease (CD). Patients with IBD are at an increased risk of developing dysplasia, which can progress to colorectal cancer (CRC) if left undetected or unresected. Endoscopy plays a pivotal role in the detection and management of dysplasia in IBD patients. This manuscript provides an in-depth review of the role of endoscopy in dysplasia detection, including disease activity assessment, mucosal healing monitoring, and early dysplasia identification. We explore emerging technologies, including artificial intelligence (AI), molecular imaging, confocal laser endomicroscopy (CLE), and wireless capsule endoscopy (WCE), which hold promise for improving dysplasia detection rates. Additionally, we discuss therapeutic endoscopy techniques and future directions in personalized surveillance strategies. With the integration of advanced endoscopic technologies and evolving guidelines, endoscopy remains a critical tool for enhancing patient outcomes and reducing CRC risk in IBD.