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Related Concept Videos

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

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

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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...
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Inflammatory Bowel Disease I: Introduction01:26

Inflammatory Bowel Disease I: Introduction

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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...
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Inflammatory Bowel Disease II: Ulcerative Colitis01:20

Inflammatory Bowel Disease II: Ulcerative Colitis

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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...
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Inflammatory Bowel Disease I: Ulcerative Colitis01:27

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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...
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Histology of the Gastrointestinal (GI) Tract01:20

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The GI tract, from beginning to end, is made up of four continuous tissue layers that adjust their structure according to their specific roles. These layers, from innermost to outermost, are known as the mucosa, submucosa, muscularis, and serosa, which are continuous with the mesentery.
The mucosa is sometimes called a mucous membrane due to its mucus-secreting features. This membrane is composed of epithelium, which directly interacts with ingested substances, and the lamina propria, a layer...
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Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

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Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
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Pattern-based histologic approach in colitis without chronic architectural damage: GIPAD recommendations.

Iacopo Panarese1, Paola Spaggiari2, Luca Albarello3

  • 1UOC di Anatomia Patologica, Azienda Ospedaliero Universitaria "Luigi Vanvitelli", Napoli, Italy.

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
|May 3, 2026
PubMed
Summary
This summary is machine-generated.

Pathologists face challenges diagnosing intestinal symptoms due to overlapping histological patterns and limited clinical data. A pattern-based approach to mucosal injury reporting is proposed to improve diagnostic accuracy in colitis.

Keywords:
Apoptotic colitisCrohn diseaseEosinophilic colitisInflammatory bowel diseaseIschemic colitisUlcerative colitis

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Area of Science:

  • Gastroenterology
  • Pathology
  • Oncology

Background:

  • Intestinal symptoms like diarrhea have diverse causes, including infections, functional disorders, inflammatory bowel disease (IBD), drug injury, and metabolic issues.
  • Histomorphological evaluation is crucial for diagnosis, but endoscopic findings can be subtle, and similar histological patterns can arise from different etiologies.
  • Novel oncologic therapies (TKIs, ICIs, CAR-T) complicate diagnosis, and incomplete pathology request forms increase misinterpretation risks.

Purpose of the Study:

  • To propose a pattern-based histological approach for reporting mucosal damage in patients with colitis.
  • To focus on non-chronic patterns of mucosal injury and their differential diagnoses.
  • To support standardized reporting and improve clinicopathological correlation.

Main Methods:

  • Review of histological patterns of mucosal injury in colitis.
  • Analysis of differential diagnoses for non-chronic patterns.
  • Emphasis on integrating histomorphology with clinical and endoscopic data.

Main Results:

  • Identified overlapping histological patterns associated with various etiologies, particularly relevant in patients on oncologic therapies.
  • Highlighted challenges posed by incomplete clinical information on pathology request forms.
  • Proposed a structured, pattern-based reporting system for mucosal injury.

Conclusions:

  • A standardized, pattern-based histological approach is essential for accurate diagnosis and management of colitis.
  • Improved clinicopathological correlation is needed, especially with complex cases involving novel therapies.
  • This approach aims to reduce diagnostic errors and guide appropriate clinical decisions.