Differential diagnosis in inflammatory bowel disease colitis

“Distinction between Crohn’s disease of the colon-rectum and ulcerative colitis or inflammatory bowel disease (IBD) type unclassified can be of pivotal importance for a tailored clinical management, as each entity often involves specific therapeutic strategies and prognosis. Nonetheless, no gold standard is available and the uncertainty of diagnosis may frequently lead to misclassification or repeated examinations. Hence, we have performed a literature search to address the problem of differential diagnosis in IBD colitis, revised current and emerging diagnostic tools and refined disease classification strategies. Nowadays, the differential diagnosis is an untangled issue, and the proper diagnosis
cannot be reached in up to 10% of patients presenting with IBD colitis.”

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Infliximab for Induction and MaintenanceTherapy for Ulcerative Colitis

Ulcerative colitis is characterized by mucosal ulceration, rectal bleeding, diarrhea, and abdominal pain. Pharmacologic management of ulcerative colitis has relied mainly on 5-aminosalicylates, corticosteroids, and immunosuppressants, including purine antimetabolites and cyclosporine. Corticosteroid dependence is a clinically important problem; furthermore, the probability of colectomy within the first five years after diagnosis ranges from 9 percent in patients with distal colitis to 35 percent in patients with total colitis, most commonly because of failed medical therapy. The cumulative risk of recurrent inflammatory bowel disease in the form of pouchitis ranges from 15.5 percent one year after the procedure to 45.5 percent 10 years after the procedure. Accordingly, new treatments for ulcerative colitis are needed.”

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Continent ileostomy modifications

Today’s discussion topics included the Barnett continent intestinal reservoir.


Worsey J, Fazio VW. (2017). Continent Ileostomy. In: Current Therapy in Colon and Rectal Surgery, 3rd ed, pgs. 204-208. Elsevier: NY.

Full-text for Emory users.

Philadelphia Illustration Dept./Elsevier

FIGURE 40-3. Barnett modification of the continent ileostomy. (Cleveland Clinic Center for Medical Art & Photography.)

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