| Theme |
Atypical cases of inflammatory bowel disease diagnosed with difficulty |
| Title |
IBD unclassified (IBDU) / indeterminate colitis (IC) |
| Author |
Junji Umeno |
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University |
| Author |
Atsushi Hirano |
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University |
| Author |
Motohiro Esaki |
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University |
| Author |
Takayuki Matsumoto |
Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Iwate Medical University |
| [ Summary ] |
Patients with inflammatory bowel disease (IBD) manifesting the overlapping clinical features of Crohn's disease (CD) and ulcerative colitis (UC) have been categorized as having indeterminate colitis (IC). It has recently been proposed that the term "IC" should be used only when definite diagnosis of either CD or UC cannot be made even after pathological evaluation of surgical specimens. The term "IBD unclassified (IBDU)" should be used in IBD cases whose diagnoses remain unconfirmed in spite of extensive clinical work-ups. Although most cases of IBDU/IC eventually evolve into typical cases of CD or UC, a subset of patients remains having IBDU because of indistinguishable clinical manifestations. While medical therapies usually applied to CD or UC are considered to be effective for IBDU/IC, the application of surgery, especially total proctocolectomy and ileal pouch-anal anastomosis, should carefully be considered in cases with refractory IBDU/IC. |