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Indeterminate Colitis/Inflammatory Bowel Disease Unclassified (IBD-U)

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Textbook of Pediatric Gastroenterology, Hepatology and Nutrition

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Abstract

The majority of patients with chronic inflammatory bowel disease (IBD) are diagnosed with either ulcerative colitis (UC) or Crohn’s disease (CD) on the basis of established clinical, endoscopic, histologic, and radiologic criteria. However, in 5–23 % of patients with chronic colitis, a definitive diagnosis of UC or CD cannot be established because the initial macroscopic appearance (either during ileocolonoscopy or following colectomy) and histologic features overlap between UC and CD. While most of these patients eventually evolve into patterns consistent with UC or CD, approximately 20–60 % retain the diagnosis of indeterminate colitis (IC) over periods as long as 5–10 years post diagnosis. This latter observation suggests that IC may constitute a separate category within the spectrum of IBD. This chapter reviews the histologic and clinical features of IC in pediatric patients and contains updated information explaining why some patients continue to be diagnosed with IC (new proposed terminology of IBD-unclassified (IBD-U).For the present, IC and IBD-U refer to chronic colitis due to idiopathic IBD for which the features of CD and UC are absent. It has been suggested that the term IC should be the preferred term after histologic evaluation of the resected colon and IBD-U used after review of biopsy specimens.

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Author information

Authors and Affiliations

  1. Section of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Chicago, Comer Children’s Hospital, Chicago, IL, 60637, USA

    Barbara S. Kirschner

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  1. Barbara S. Kirschner
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Correspondence to Barbara S. Kirschner .

Editor information

Editors and Affiliations

  1. Department of Pediatrics, University of Chicago, Chicago, Illinois, USA

    Stefano Guandalini

  2. Clinical Director Child Health King’s College Hospital, Professor and Director Pediatric Liver, GI and Nutrition Center, London, United Kingdom

    Anil Dhawan

  3. Department of Pediatrics, Hebrew University Hadassah Hospital, Jerusalem, Israel

    David Branski

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Kirschner, B. (2016). Indeterminate Colitis/Inflammatory Bowel Disease Unclassified (IBD-U). In: Guandalini, S., Dhawan, A., Branski, D. (eds) Textbook of Pediatric Gastroenterology, Hepatology and Nutrition. Springer, Cham. https://doi.org/10.1007/978-3-319-17169-2_29

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  • DOI: https://doi.org/10.1007/978-3-319-17169-2_29

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-17169-2

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