Inflammatory bowel disease unclassified

Abstract

Abstract:Objective: Inflammatory bowel diseases (IBDs) are idiopathic, chronic, and inflammatory intestinal disorders. The two main types, ulcerative colitis (UC) and Crohn's disease (CD), sometimes mimic each other and are not readily distinguishable. The purpose of this study was to present a series of hospitalized cases, which could not initially be classified as a subtype of IBD, and to try to note roles of the terms indeterminate colitis (IC) and inflammatory bowel disease unclassified (IBDU) when such a dilemma arises. Methods: Medical records of 477 patients hospitalized due to IBD, during the period of January 2002 to April 2009, were retrospectively studied in the present paper. All available previous biopsies from endoscopies of these patients were reanalyzed. Results: Twenty-seven of 477 IBD patients (5.7%) had been initially diagnosed as having IBDU. Of them, 23 received colonoscopy and histological examinations in our hospital. A total of 90% (9/10) and 66.7% (4/6) of patients, respectively, had a positive finding via wireless capsule endoscopy (CE) and double-balloon enteroscopy (DBE). The barium-swallow or small bowel follow-through (SBFT) was performed on 11 patients. Positive changes were observed under computer tomographic (CT) scanning in 89.5% (17/19) of patients. Reasonable treatment strategies were employed for all patients. Conclusions: Our data indicate that IBDU accounts for 5.7% of initial diagnoses of IBD. The definition of IBDU is valuable in clinical practice. For those who had no clear clinical, endoscopic, histological, or other features affording a diagnosis of either UC or CD, IBDU could be used parenthetically.

Disease course of inflammatory bowel disease unclassified in a European population‐based inception cohort: An Epi‐IBD study

“…Almost half of patients in this cohort were managed on 5‐ASA alone, and only a few required treatment with immunomodulators and/or biologicals. Overall, both treatment choices, as well as surgery and hospitalization rates, were similar to UC patients from the same cohort, which has also been reported in other cohorts . A high proportion of patients whose diagnosis was eventually changed to UC underwent colectomy or needed biological therapy, although the number of patients included in this part of the analysis was low.…”

“…Overall, both treatment choices, as well as surgery and hospitalization rates, were similar to UC patients from the same cohort, 14 which has also been reported in other cohorts. 7,27 A high proportion of patients whose diagnosis was eventually changed to UC underwent colectomy or needed biological therapy, although the number of patients included in this part of the analysis was low. These results therefore should be interpreted with care.…”

The profile of inflammatory bowel disease in natives of Western Himalayas

“…The idiopathic Inflammatory Bowel Diseases (IBD) comprise three types of chronic intestinal disorders: Crohn's Disease (CD) Ulcerative Colitis (UC) and Inflammatory Bowel Disease Undifferentiated (IBDU)/ Indeterminate Colitis. 1 The incidence and prevalence rates of IBD in Asian countries are still low compared with those of Western countries, but have been increasing rapidly during the past decades. 2 The incidence of IBD has dramatically increased during the 20th century, and in the developed nations is as high as 20 and 24 cases per 100,000 person-years for CD and UC, respectively.…”

Clinical Factors Associated with the Development of Crohnʼs Disease in Inflammatory Bowel Disease-unclassified Patients Undergoing Ileal Pouch–anal Anastomosis

“…Referral center bias must be considered, and also our definition of patients with IBDU may differ from other IBD centers, which had reported different results. 14 We acknowledge the inherent problem of the lack of consensus on the definition of IBDU as a disease entity, [16][17][18][19] but as a tertiary IBD center, we have consistently used the above definition for our practice. In patients with a preoperative diagnosis of IBDU, it would not be unexpected that the rate of developing CD be higher than the estimated 1% to 10% reported in other series of patients that included both UC and IB-DU.…”

“…It is evident that the variations in the definitions for IBDU can be either too stringent or all encompassing, including as many permutations of the various features that cannot be classified as either UC or CD. [16][17][18] With such a varying background, it is not surprising that the mechanism of this conversion of IBDU to CD remains elusive and difficult to investigate. Finally, our results may reflect that as an IBD surgery team, we may be more aggressive in performing IPAA for IBDU as compared with other institutions especially because we did demonstrate that the long-term outcomes of the ileal pouch were similar in patients with UC or IBDU who underwent IPAA.…”