There is growing evidence of the importance of mucosal healing (MH) in ulcerative colitis, but whether or not
it should be a future primary treatment goal is still under intense discussion. Within the last decade many clinical trials
have focused not only on response and remission rates but also on achievement of MH, while in clinical practice we still
make treatment decisions on the basis of clinical symptoms. There is so far no internationally accepted definition of MH
and the tools for assessment of MH vary from biomarkers to endoscopy with histological evaluation on the basis of several
different scores and indices. This review will focus on present data dealing with methods to assess MH and the importance
of MH for the future course of disease, the need for colectomy or risk of developing colorectal cancer and the patient’s
quality of life. Many questions remain: How and when do we best assess MH? How rapidly do we need to achieve
MH? What is the optimal time point to discontinue treatment after achieving MH? Well defined prospective studies are
needed to address these important questions.
Keywords: Biomarkers, cancer risk, clinical outcome, hospitalization, imaging, inflammatory bowel disease, mucosal healing,
quality of life, relapse, ulcerative colitis.
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