Pathology of idiopathic inflammatory bowel disease

The term inflammatory bowel disease (IBD) is used to encompass Crohn's disease and ulcerative colitis. These conditions are of uncertain cause and are characterized by immune destruction of the gut. In the case of ulcerative colitis the process is confined to the large intestine while Crohn's disease can involve any part of the gastrointestinal tract, often in a discontinuous fashion. It is important to make an accurate diagnosis of inflammatory bowel disease and to exclude other causes of inflammation, particularly infection. Diagnosis depends on consideration of endoscopic, radiological and pathological findings. Adenocarcinoma is an important complication, particularly in extensive ulcerative colitis, and a major driver of endoscopic surveillance in these patients.