Recent IBD studies have identified mucosal healing as a key objective and parameter for prognosis beyond symptom control. It may be defined after resolution of endoscopically visible ulcers. In clinical settings how this goal can be achieved? How this surrogate marker can be scoped by colonoscopy or enteroscopy? What timing might be best to evaluate after start of initial therapy, in short or in long term? What class of therapy (immunosuppressant, steroids, biologics, leucocytapheresis, enteral nutrition, prebiotics, probiotics, or any other intervention) would be possible to reach this goal? How mucosal change should be assigned endoscopic score in IBD? These challenges should be discussed between Japanese and overseas participants at this symposium.