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 16 January 2018

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News

Diagnostic problems during the initial years after IBD onset

Doctors show in this month's issue of the Scandanavian Journal of Gastroenterology that changes in diagnosis occur in patients initially classified as indeterminate colitis or possible IBD.

News image

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An exact diagnosis and subclassifications of inflammatory bowel disease (IBD) may be difficult even after clinical, radiological and histological examinations.

A correct subclassification is important for the success of both medical and surgical therapeutic strategies.

However, there is a dearth of information available on the frequency of changes in diagnosis in population-based studies.

Dr Magne Henriksen and colleagues from Norway prospectively re-evaluated the diagnosis in an unselected cohort of IBD patients.

The team of doctors assessed the patients during the first 5 years after the initial diagnosis.

Patients classified as IBD or possible IBD in the period 1990 to 1994, known as the IBSEN cohort had their diagnosis re-evaluated after 1 and 5 years.

Initially, the patients were classified as ulcerative colitis, Crohn's disease, indeterminate colitis or possible IBD.

At the 5-year visit, the doctors classified the patients as ulcerative colitis, Crohn's disease or non-IBD.

The team of doctors identified a total of 843 patients.

Indeterminate colitis classifications were re-diagnosed as non-IBD after 5 years
Scandanavian Journal of Gastroenterology

Of these, 518 had ulcerative colitis, 221 had Crohn's disease, 40 had indeterminate colitis and 64 presented with possible IBD.

Clinical information was available for 94% of the patients who survived after 5 years.

The doctors found a change in diagnosis in 9% of the patients initially classified as ulcerative colitis or Crohn's disease.

A change to non-IBD was more frequent than a change between ulcerative colitis and Crohn's disease.

A large proportion of patients initially classified as indeterminate colitis or possible IBD were diagnosed as non-IBD after 5 years.

The team noted that when IBD was confirmed in these groups, ulcerative colitis was more frequent than Crohn's disease.

The doctors observed 2 changes in diagnosis during follow-up in 3% of the patients.

The changes in diagnosis were more frequent in patients initially classified as indeterminate colitis or possible IBD.

Dr Henriksen's team concludes, “There are obvious diagnostic problems in a minority of patients with IBD.”

“A systematic follow-up is therefore important in these patients.”

Scand J Gastroenterol 2006: 41(9): 1037-43
11 September 2006

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