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Diagnosis and Monitoring in Inflammatory Bowel Disease: Who, When, Where, and How

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Inflammatory Bowel Disease

Part of the book series: Clinical Gastroenterology ((CG))

Abstract

Inflammatory bowel disease (IBD) is an autoimmune disorder affecting the gastrointestinal tract. It is generally categorized into Crohn’s disease (CD) and ulcerative colitis (UC). These disease processes are more recently thought of as a disease continuum, with distinct features as well as substantial overlap (Cleynen, et al. Lancet 387(10014):156–167, 2016). There is no single test that can definitely establish the diagnosis of IBD or reliably distinguish between the two disease states of CD and UC. Additionally, IBD can present atypically or overlap with other disease processes. As a result of the complexity involved in making this diagnosis, there still remain substantial delays from the onset of symptoms to the diagnosis. A recent US study found an average delay of 9.5 months from symptoms to diagnosis for Crohn’s disease and 3.1 months for ulcerative colitis (Nguyen, et al. Inflamm Bowel Dis 23(10):1825–1831, 2017). This additional time to diagnosis for Crohn’s is borne out in several other international studies (Novacek, et al. Wien Klin Wochenschr 131(5–6):104–112, 2019; Zaharie, et al. J Crohns Colitis 10(3):306–314, 2016; El Mouzan, et al. Saudi J Gastroenterol 25:257–261, 2019). Intervening early in the disease course has significant implications on prognosis (Halme, et al. World J Gastroenterol 12(23):3668–3672, 2006), as early treatment can restore baseline function, while delays often result in permanent structural damage.

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Authors and Affiliations

  1. Department of Internal Medicine, NYU Langone Hospital Long Island, Mineola, NY, USA

    Anthony Passarella

  2. Dayanand Medical College, Ludhiana, Punjab, India

    Prabhsharn Grewal

  3. Division of Gastroenterology, NYU Langone Hospital Long Island, Mineola, NY, USA

    Raluca Vrabie

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  1. Zucker School of Medicine at Hofstra/Northwell, Mather Gastroenterology, Port Jefferson, NY, USA

    Ramona Rajapakse

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Passarella, A., Grewal, P., Vrabie, R. (2021). Diagnosis and Monitoring in Inflammatory Bowel Disease: Who, When, Where, and How. In: Rajapakse, R. (eds) Inflammatory Bowel Disease. Clinical Gastroenterology. Humana, Cham. https://doi.org/10.1007/978-3-030-81780-0_2

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