[New aspects of Crohn disease and ulcerative colitis: current diagnosis]

Differential diagnosis of inflammatory bowel disease includes careful history taking, microbiological stool tests and endoscopy. Radiological procedures are required only in patients with Crohn's disease in order to demonstrate small bowel lesions or fistulae. The clinical relevance of recent scintigraphic techniques (67-gallium-citrate, 111-indium granulocytes, 99m-technetium-sucralfate) needs further exploration. Careful follow-up of patients with ulcerative colitis and Crohn's disease is mandatory once the duration of symptoms exceeds 10 years, in view of the high risk of development of carcinoma. The search for severe dysplasia is difficult and time consuming. Certain additional tests promise to be of value in detecting early malignancy, but these are not yet suited for routine clinical follow up.