Mucosal healing in inflammatory bowel disease: impossible ideal or therapeutic target?

The main goal of treatment for Crohn's disease and ulcerative colitis has always been the induction and maintenance of symptomatic improvement or at best remission. It has been shown by many studies that the long-term outcome of these diseases is not influenced by standard treatments and that the need for surgery is not decreasing in this population over the years. There is recent evidence that with immunosuppression and treatment with infliximab long-term healing of the bowel can be achieved and that this affects the outcome of both Crohn's disease and ulcerative colitis. We propose that future studies should focus on healing and disease course as primary outcome measures.