Advances in endoscopy in IBD diagnostics and management

Endoscopy remains an essential modality for the diagnosis, risk stratification, monitoring, and therapy of inflammatory bowel disease (IBD). Recent advances, including high-definition imaging, dye-based and virtual chromoendoscopy, and AI-assisted interpretation, improve dysplasia detection and grading of inflammatory activity, enabling treat-to-target care. In Crohn's disease, small-bowel and pan-enteric capsule endoscopy expand noninvasive assessment, while device-assisted enteroscopy allows targeted biopsy and therapy when tissue or intervention is required. Standardized scoring systems (MES/UCEIS, SES-CD, Rutgeerts) support objective follow-up, including early postoperative evaluation. Therapeutically, endoscopic balloon dilation for short strictures and advanced resection techniques (EMR/ESD) for visible dysplasia in experienced centers provide organ-sparing options; endoscopic fistula closure remains investigational. This review synthesizes contemporary trials and ECCO, ESGE, and ASGE guidance into practical algorithms that promote precise surveillance and timely intervention, positioning endoscopy as a functional, predictive, and increasingly personalized tool in IBD care.