Clinical aspects of mucosal healing in inflammatory bowel diseases: what is it and what is the real value for the everyday practice?

Abstract

The course of inflammatory bowel diseases is heterogeneous and varies over time. Therefore, the search for predictive factors has increasingly become the focus of research. Mucosal healing has emerged as an important objective, as evidence indicates that it is associated with improved disease outcome. Nevertheless, many unsolved questions remain, including the definition of complete or partial healing as well as the best assessment method using endoscopic or imaging techniques, most of which are relatively invasive and expensive procedures, which therefore are not ideal for frequent monitoring and it is not clear. This review summarizes the available evidence in order to assist clinicians when assessing the mucosal status in the everyday practice.

Keywords::

• Crohn’s disease
• disease course
• mucosal healing
• predictive markers
• ulcerative colitis

Financial & competing interests disclosure

In the last 2 years, PL Lakatos has received consultant and/or lecture fees from AbbVie, MSD-Hungary and Ferring. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• • Search for predictive markers is one major focus area in inflammatory bowel disease.

• • Mucosal healing (MH) has emerged as a major treatment objective.

• • MH is reported to be associated with relapse, hospitalization, surgery rates and the risk of colorectal cancer in ulcerative colitis.

• • There is no gold-standard definition of MH and multiple scoring systems exist.

• • Additional research is needed to prove if optimization of therapies to achieve MH is leading to superior disease outcomes.