PREPAREDNESS FOR AND PITFALLS OF ENDOSCOPIC DIAGNOSIS OF INFLAMMATORY DISEASES OF THE BOWEL

Abstract

Endoscopic diagnosis of inflammatory diseases of the intestinal tract, including inflammatory bowel disease, is generally more difficult than that of tumors. This is because the presence of pathology is not definitive for inflammation, and the causes and endoscopic images are more diverse than those of tumors. Inflammation is often atypical, and the diagnosis should not be based solely on the endoscopic image but should also consider the patientʼs medical history and other factors. The diagnosis of typical cases of both ulcerative colitis and Crohnʼs disease is not very difficult, but knowledge of atypical cases is necessary for an accurate diagnosis; for example, there is often no endoscopic inflammation of the rectum in ulcerative colitis, and diffuse inflammation may also occur in Crohnʼs disease. Diseases that are important to differentiate from inflammatory bowel disease include infectious enteritis, drug-induced enteritis, and eosinophilic gastroenteritis, all requiring a more detailed history than just an endoscopic picture.