When it is not inflammatory bowel disease: differential diagnosis

Area of Science:

• Gastroenterology
• Internal Medicine
• Pediatrics

Background:

• Inflammatory bowel diseases (IBD) present heterogeneously, complicating diagnosis.
• Various conditions mimic IBD, including infections, infestations, and drug toxicity.
• Emerging differential diagnoses include monogenic gastrointestinal inflammatory disorders, especially in pediatric populations.

Purpose of the Study:

• To review the differential diagnosis of IBD within specific clinical and demographic contexts.
• To discuss IBD mimics in young children, elderly patients, and immunosuppressed individuals.
• To emphasize the importance of recognizing specific diagnoses that necessitate tailored treatment strategies.

Main Methods:

• Literature review focusing on recent findings and concepts in IBD differential diagnosis.
• Analysis of specific conditions relevant to distinct patient groups.
• Integration of clinical and demographic factors into diagnostic considerations.

Main Results:

• Focus on monogenic diseases in young children as a key differential.
• Discussion of diverticular disease-associated colitis in the elderly.
• Inclusion of toxic colitis in immunosuppressed patients (e.g., on mycophenolate mofetil, ipilimumab).

Conclusions:

• Clinicians must be aware of specific diagnoses that mimic IBD.
• Early recognition of these mimics is crucial for appropriate management.
• Specific diagnoses may require treatment distinct from that for idiopathic IBD.