Feature Article

Is it IBD? Making an accurate and prompt diagnosis

ABDUL SHAIKH, Jane Andrews

Figures

© pixel-shot/shutterstock model used for illustrative purposes only
© pixel-shot/shutterstock model used for illustrative purposes only

Abstract

Abdominal symptoms thought to be related to the lower gut (ileum and colon) are common, and most do not represent inflammatory bowel disease. Making an accurate and prompt diagnosis in general practice can be challenging at times. However, being aware of the range of differential diagnoses and the ways in which we can best estimate the pretest probability of each condition to enhance diagnostic accuracy is relatively straightforward.

Key Points

  • The cardinal symptoms of diarrhoea (with or without blood) and abdominal pain represent a common clinical scenario in general practice, and not all patients with these symptoms have inflammatory bowel disease (IBD) or require extensive work up or referral to a specialist.
  • There is no single test that diagnoses IBD; diagnosis is based on a combined approach of clinical history, biomarkers, endoscopic, radiological and histological assessment.
  • Many non-IBD-related colitides share basic clinical features with IBD; however, symptom pattern, time course, age group and other risk factors identifiable in the patient’s history can be used to guide accurate diagnosis.
  • Reviewing potential differential diagnoses should guide the search for the underlying cause.

Figures

© pixel-shot/shutterstock model used for illustrative purposes only
© pixel-shot/shutterstock model used for illustrative purposes only