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Related Concept Videos

Inflammatory Bowel Disease I: Introduction01:26

Inflammatory Bowel Disease I: Introduction

Inflammatory bowel disease is a group of chronic disorders marked by recurrent inflammation of the gastrointestinal tract due to an abnormal immune response against gut microflora. This leads to tissue damage. The two main forms are Crohn’s disease and ulcerative colitis.Crohn’s DiseaseCrohn’s disease is a relapsing inflammatory disorder that can affect any part of the GI tract, from the mouth to the anus. It involves all layers of the bowel wall (transmural) and shows “skip lesions” in which...
Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy

Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
Inflammatory Bowel Disease II: Ulcerative Colitis01:20

Inflammatory Bowel Disease II: Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal BarrierA...
Inflammatory Bowel Disease IV: Clinical Manifestations01:20

Inflammatory Bowel Disease IV: Clinical Manifestations

Inflammatory bowel disease (IBD) encompasses two major chronic disorders—ulcerative colitis and Crohn’s disease—each characterized by relapsing episodes of gastrointestinal inflammation. Although they share certain clinical features, their patterns of involvement and manifestations differ in ways that aid diagnosis and guide management.Ulcerative ColitisUlcerative colitis is limited to the colon and rectum and involves continuous inflammation of the mucosal layer. The disease course is marked...
Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...

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Related Experiment Video

Updated: May 25, 2026

Flexible Colonoscopy in Mice to Evaluate the Severity of Colitis and Colorectal Tumors Using a Validated Endoscopic Scoring System
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Flexible Colonoscopy in Mice to Evaluate the Severity of Colitis and Colorectal Tumors Using a Validated Endoscopic Scoring System

Published on: October 16, 2013

Is indeterminate colitis determinable?

William J Tremaine1

  • 1Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, USA. tremaine.william@mayo.edu

Current Gastroenterology Reports
|February 9, 2012
PubMed
Summary

Indeterminate colitis, also known as inflammatory bowel disease unclassified (IBDU), affects 10% of colitis patients. Diagnostic challenges persist, with serologic and imaging studies lacking definitive predictive value for distinguishing subtypes.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Immunology

Background:

  • Indeterminate colitis affects approximately 10% of patients with inflammatory bowel disease (IBD) causing colitis.
  • The prevalence of indeterminate colitis has remained consistent over the past 33 years, despite advancements in diagnostic technologies.
  • This condition is more commonly observed in pediatric populations.

Purpose of the Study:

  • To review the diagnostic challenges and clinical implications of indeterminate colitis, also referred to as colonic inflammatory bowel disease unclassified (IBDU).
  • To discuss the utility of serologic markers like ASCA and pANCA in differentiating IBDU from established diagnoses.
  • To highlight the limitations of current diagnostic modalities in definitively classifying IBDU.

Main Methods:

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Investigating Intestinal Inflammation in DSS-induced Model of IBD
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  • Literature review of studies on indeterminate colitis and IBDU.
  • Analysis of serologic markers (ASCA, pANCA) for diagnostic utility.
  • Evaluation of endoscopic, imaging, genetic, and clinical data in IBDU diagnosis.
  • Review of outcomes for patients with IBDU undergoing surgical intervention.

Main Results:

  • Serologic markers such as anti-Saccharomyces cerevisiae (ASCA) and perinuclear anti-cytoplasmic antibody (pANCA) show utility in distinguishing IBDU from ulcerative colitis and Crohn's disease.
  • Current serologic, genetic, endoscopic, and imaging studies lack sufficient positive predictive value for a definitive diagnosis of Crohn's colitis or ulcerative colitis in IBDU patients.
  • Patients with IBDU undergoing proctocolectomy with ileal pouch-anal anastomosis experience higher complication rates compared to ulcerative colitis patients.

Conclusions:

  • A significant subgroup of patients with indeterminate colitis remain durably undiagnosed, despite potential evolution to characteristic ulcerative colitis or Crohn's disease.
  • Despite diagnostic advancements, indeterminate colitis (IBDU) remains a persistent challenge in IBD management.
  • Further research is needed to improve diagnostic accuracy and patient outcomes for indeterminate colitis.