Update for indeterminate colitis

Research output: Contribution to journalReview article

Abstract

The distinctive diagnosis of Crohn's disease (CD) and ulcerative colitis (UC) is based on a combination of clinical, histologic, endoscopic, and radiologic data. Both UC and CD show characteristic, but non-specific, pathological features that may overlap and result in a diagnosis of indeterminate colitis (IC), which was proposed by pathologists for colectomy specimens in 1978, usually from patients operated on for severe colitis, especially in cases of acute fulminant disease of the colorectum. The subgroup of patients with an uncertain diagnosis has been classified as IC. Later, the same terminology was used for patients showing no clear clinical, endoscopic, histologic, or other features allowing a diagnosis of either UC or CD. More recently, the term IC has been applied to biopsy material when it is not been possible to differentiate between UC and CD. However, this term IC has suffered varying definitions, which in addition to numerous difficulties in diagnosing inflammatory bowel disease, has led to much confusion. In resected specimens, the term colitis of uncertain type or etiology is preferred. Over time, the majority of patients remain with a diagnosis of IC or show symptoms similar to UC. Ileal pouch anal anastomosis can be performed in such patients, with outcomes of pouch failure and with functional outcomes that are similar to those in patients with UC, but with increased risk of postoperative pouch complications. This review addresses the definition of indeterminate colitis, its pathology, its natural history, and the outcomes of restorative proctocolectomy.

Original languageEnglish
Pages (from-to)165-170
Number of pages6
JournalJournal of the Korean Society of Coloproctology
Volume26
Issue number3
DOIs
Publication statusPublished - 2010 Jun 1

Fingerprint

Colitis
Ulcerative Colitis
Crohn Disease
Restorative Proctocolectomy
Colonic Pouches
Colectomy
Acute Disease
Natural History
Inflammatory Bowel Diseases
Terminology
Pathology
Biopsy

Keywords

  • Colitis ulcerative
  • Crohn's disease
  • Inflammatory bowel diseases
  • Pathology
  • Proctocolectomy restorative

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Update for indeterminate colitis. / Um, Jun Won.

In: Journal of the Korean Society of Coloproctology, Vol. 26, No. 3, 01.06.2010, p. 165-170.

Research output: Contribution to journalReview article

@article{dbb1cd4d10094fc0bc7bd66f867f0bce,
title = "Update for indeterminate colitis",
abstract = "The distinctive diagnosis of Crohn's disease (CD) and ulcerative colitis (UC) is based on a combination of clinical, histologic, endoscopic, and radiologic data. Both UC and CD show characteristic, but non-specific, pathological features that may overlap and result in a diagnosis of indeterminate colitis (IC), which was proposed by pathologists for colectomy specimens in 1978, usually from patients operated on for severe colitis, especially in cases of acute fulminant disease of the colorectum. The subgroup of patients with an uncertain diagnosis has been classified as IC. Later, the same terminology was used for patients showing no clear clinical, endoscopic, histologic, or other features allowing a diagnosis of either UC or CD. More recently, the term IC has been applied to biopsy material when it is not been possible to differentiate between UC and CD. However, this term IC has suffered varying definitions, which in addition to numerous difficulties in diagnosing inflammatory bowel disease, has led to much confusion. In resected specimens, the term colitis of uncertain type or etiology is preferred. Over time, the majority of patients remain with a diagnosis of IC or show symptoms similar to UC. Ileal pouch anal anastomosis can be performed in such patients, with outcomes of pouch failure and with functional outcomes that are similar to those in patients with UC, but with increased risk of postoperative pouch complications. This review addresses the definition of indeterminate colitis, its pathology, its natural history, and the outcomes of restorative proctocolectomy.",
keywords = "Colitis ulcerative, Crohn's disease, Inflammatory bowel diseases, Pathology, Proctocolectomy restorative",
author = "Um, {Jun Won}",
year = "2010",
month = "6",
day = "1",
doi = "10.3393/jksc.2010.26.3.165",
language = "English",
volume = "26",
pages = "165--170",
journal = "Annals of Coloproctology",
issn = "2287-9714",
publisher = "Korean Society of Coloproctology",
number = "3",

}

TY - JOUR

T1 - Update for indeterminate colitis

AU - Um, Jun Won

PY - 2010/6/1

Y1 - 2010/6/1

N2 - The distinctive diagnosis of Crohn's disease (CD) and ulcerative colitis (UC) is based on a combination of clinical, histologic, endoscopic, and radiologic data. Both UC and CD show characteristic, but non-specific, pathological features that may overlap and result in a diagnosis of indeterminate colitis (IC), which was proposed by pathologists for colectomy specimens in 1978, usually from patients operated on for severe colitis, especially in cases of acute fulminant disease of the colorectum. The subgroup of patients with an uncertain diagnosis has been classified as IC. Later, the same terminology was used for patients showing no clear clinical, endoscopic, histologic, or other features allowing a diagnosis of either UC or CD. More recently, the term IC has been applied to biopsy material when it is not been possible to differentiate between UC and CD. However, this term IC has suffered varying definitions, which in addition to numerous difficulties in diagnosing inflammatory bowel disease, has led to much confusion. In resected specimens, the term colitis of uncertain type or etiology is preferred. Over time, the majority of patients remain with a diagnosis of IC or show symptoms similar to UC. Ileal pouch anal anastomosis can be performed in such patients, with outcomes of pouch failure and with functional outcomes that are similar to those in patients with UC, but with increased risk of postoperative pouch complications. This review addresses the definition of indeterminate colitis, its pathology, its natural history, and the outcomes of restorative proctocolectomy.

AB - The distinctive diagnosis of Crohn's disease (CD) and ulcerative colitis (UC) is based on a combination of clinical, histologic, endoscopic, and radiologic data. Both UC and CD show characteristic, but non-specific, pathological features that may overlap and result in a diagnosis of indeterminate colitis (IC), which was proposed by pathologists for colectomy specimens in 1978, usually from patients operated on for severe colitis, especially in cases of acute fulminant disease of the colorectum. The subgroup of patients with an uncertain diagnosis has been classified as IC. Later, the same terminology was used for patients showing no clear clinical, endoscopic, histologic, or other features allowing a diagnosis of either UC or CD. More recently, the term IC has been applied to biopsy material when it is not been possible to differentiate between UC and CD. However, this term IC has suffered varying definitions, which in addition to numerous difficulties in diagnosing inflammatory bowel disease, has led to much confusion. In resected specimens, the term colitis of uncertain type or etiology is preferred. Over time, the majority of patients remain with a diagnosis of IC or show symptoms similar to UC. Ileal pouch anal anastomosis can be performed in such patients, with outcomes of pouch failure and with functional outcomes that are similar to those in patients with UC, but with increased risk of postoperative pouch complications. This review addresses the definition of indeterminate colitis, its pathology, its natural history, and the outcomes of restorative proctocolectomy.

KW - Colitis ulcerative

KW - Crohn's disease

KW - Inflammatory bowel diseases

KW - Pathology

KW - Proctocolectomy restorative

UR - http://www.scopus.com/inward/record.url?scp=77954728489&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77954728489&partnerID=8YFLogxK

U2 - 10.3393/jksc.2010.26.3.165

DO - 10.3393/jksc.2010.26.3.165

M3 - Review article

VL - 26

SP - 165

EP - 170

JO - Annals of Coloproctology

JF - Annals of Coloproctology

SN - 2287-9714

IS - 3

ER -