Endoscopic evaluation of surgically altered bowel in inflammatory bowel disease: a consensus guideline from the Global Interventional Inflammatory Bowel Disease Group

Lancet Gastroenterol Hepatol. 2021 Jun;6(6):482-497. doi: 10.1016/S2468-1253(20)30394-0. Epub 2021 Apr 17.


The majority of patients with Crohn's disease and a proportion of patients with ulcerative colitis will ultimately require surgical treatment despite advances in diagnosis, therapy, and endoscopic interventions. The surgical procedures that are most commonly done include bowel resection with anastomosis, strictureplasty, faecal diversion, and ileal pouch. These surgical treatment modalities result in substantial alterations in bowel anatomy. In patients with inflammatory bowel disease, endoscopy plays a key role in the assessment of disease activity, disease recurrence, treatment response, dysplasia surveillance, and delivery of endoscopic therapy. Endoscopic evaluation and management of surgically altered bowel can be challenging. This consensus guideline delineates anatomical landmarks and endoscopic assessment of these landmarks in diseased and surgically altered bowel.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Anastomosis, Surgical / methods
  • Anatomic Landmarks / diagnostic imaging
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / surgery
  • Colonic Pouches / adverse effects
  • Consensus
  • Constriction, Pathologic / surgery
  • Crohn Disease / diagnosis
  • Crohn Disease / surgery
  • Digestive System Surgical Procedures / adverse effects*
  • Endoscopy / methods*
  • Humans
  • Inflammatory Bowel Diseases / surgery*
  • Intestines / anatomy & histology
  • Intestines / pathology*
  • Intestines / surgery
  • Middle Aged
  • Practice Guidelines as Topic
  • Proctocolectomy, Restorative / methods
  • Recurrence
  • Severity of Illness Index