How often do you do a colonoscopy for a patient with Crohn's disease under treatment with immunomodulators (Infliximab or Adalimumab) in absence of any symptoms?
Not necessarily and it depends on the patient. If a lower risk Crohn's patient is feeling well and has normal labs (cbc, CRP and/or ESR, fecal calprotectin, albumin) there is no need to assess for mucosal healing endoscopically. If the patient is higher risk (large territory involved, peri-anal disease, stricturing or penetrating disease, young age, smoker) and/or has symptoms that you are not sure are related to Crohn's, and/or has abnormalities in lab values, I generally perform the endosopy to assess the extent and severity of mucosal inflammation.