Endoscopic evaluation of inflammatory bowel disease (IBD), including ulcerative colitis and Crohn’s disease, relies on assessing the disease’s extent and activity and monitoring the responses to medical therapies, with mucosal healing as a predictor of future disease course. Endoscopic scoring systems have been advised for evaluating the prognosis and efficacy of medical treatment in patients with IBD. Endoscopic assessment of the severity of inflammation with scoring systems provides objectivity, uniformity, and standardization of reporting of mucosal appearances. Despite endoscopic scoring systems’ limitations, such as complexity, subjective interpretative features, and lack of validation for some, these systems remain a valuable tool for augmenting clinical decision-making and ultimately appropriate treatment targets and satisfactory patient outcomes. Training and online tools can facilitate broader utilization by gastroenterologists, whereas using AI systems for endoscopic scoring may provide further improvement and standardization.
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