Current approaches to disease severity and therapy effectiveness assessment in patients with inflammatory bowel disease.

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Abstract

Inflammatory bowel disease (IBD) is a group of chronic recurrent disorders, Crohn's disease and ulcerative colitis being its two major types. IBD patients require continuous lifetime monitoring of disease activity and effects of therapeutic interventions, achievement of stable remission being the goal of the current 'treat-to-target' strategy. This review considers a wide range of approaches applied for this purpose. Although ileocolonoscopy combined with histological evaluation and now employing modern endoscopic techniques is still regarded as the gold diagnostic standard, its inability of visualizing small intestine is a limitation. Alternative non-invasive techniques such as capsule endoscopy and, especially, cross-sectional imaging, comprising computed tomography enterography, magnetic resonance enterography, and intestinal ultrasound, are becoming increasingly popular. In addition, the use of molecular biomarkers detectable in human body fluids is a rapidly developing area, and recent rapid progress in gut microbiome research promises to add a new dimension to it. It is also anticipated that new approaches based upon multi-omics can identify new composite biomarkers useful for IBD monitoring. Artificial intelligence-driven integration of abundant information provided by various diagnostic and analytical modalities outlined in this review may help in transforming the current 'one-size-fits-all' treatment paradigm into a truly personalized model of IBD care.

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