Chromoendoscopy in inflammatory bowel disease.

Chromoendoscopy with methylene blue or indigo carmine significantly increases the diagnostic yield of finding intraepithelial neoplasia in patients with longstanding colitis. The number needed to treat is 14 for panchromoendoscopy to identify 1 additional patient with dysplasia. Chromoendoscopy can greatly facilitate the identification of flat lesions harboring intraepithelial neoplasia. Chromoendoscopy can guide biopsies and clearly reduces the amount of biopsies that are needed per patient. Magnifying endoscopy or CLE are additional techniques, which can be used in conjunction with chromoendoscopy to further reduce the amount of biopsies and to further increase the diagnostic yield. Chromoendoscopy is an established clinical procedure and recommended by many gastroenterological societies for surveillance of patients with longstanding ulcerative colitis. Thus, intravital staining should be an essential part of the diagnostic armamentarium of every colonoscopist.