Colitis pp 107-140 | Cite as

Inflammatory Bowel Diseases

  • Karel Geboes
  • Olivier Dewit
  • Tom G. Moreels
  • Gavino Faa
  • Anne Jouret-Mourin


Inflammatory bowel disease (IBD) is a group of chronic idiopathic inflammatory conditions. The two major types are ulcerative colitis (UC) which affects the colon and Crohn’s disease (CD) which can involve the whole gastrointestinal tract but is most common in the terminal ileum and colon. There is a genetic predisposition for IBD, and patients with this condition are more prone to the development of malignancy. Further types to be considered are indeterminate colitis (IC) and inflammatory bowel disease unclassified (IBDU). These are essentially “temporary diagnoses” when the difference between UC and CD cannot be established definitely at the time of presentation. IC should be used when examination of surgical samples is available together with clinical, serological, and imaging data, while IBDU is used for patients from whom only endoscopic biopsies are available. CD and UC must be considered in the differential diagnosis of clinically acute colitis because of differences in treatment strategies between infections and IBD. The differential diagnosis is particularly important when the complaints are persisting. Histology plays a key role in the diagnosis. Major diagnostic features of UC are architectural distortion and basal plasmacytosis. It has been suggested that “microscopic colitis” would also be member of the chronic inflammatory bowel diseases.


Inflammatory bowel disease (IBD) Ulcerative colitis Crohn’s disease Crypt architecture Crypt atrophy Bifid crypt Crypt distortion Basal plasmacytosis Active inflammatory parameters Non-active inflammatory parameters Cryptitis Crypt abscess Quiescent disease Inactive disease Disease activity Activity score Histological activity score Cytomegalovirus (CMV) Paneth cell metaplasia Ulceration Erosion Mucin depletion Transmucosal inflammation Segmental inflammation Skip area Transmural inflammation Fistula Granuloma Aphthoid ulcer Epithelioid cell Microgranuloma CARD15/NOD2 Toll-like receptor Skip lesion Focal inflammation Patchy inflammation Pseudopyloric metaplasia Hypercrinia Indeterminate colitis IBD unclassified Effect of treatment Multistep biopsies 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Karel Geboes
    • 1
    • 2
  • Olivier Dewit
    • 3
  • Tom G. Moreels
    • 3
  • Gavino Faa
    • 4
  • Anne Jouret-Mourin
    • 5
  1. 1.Department of PathologyGhent University HospitalGhentBelgium
  2. 2.Department of PathologyKU LeuvenLeuvenBelgium
  3. 3.Department of GastroenterologyCliniques Universitaires St Luc, UCLBrusselsBelgium
  4. 4.Division of Pathology, Department of Surgical SciencesUniversity Hospital San Giovanni di Dio, University of CagliariCagliariItaly
  5. 5.Department of PathologyCliniques Universitaires St Luc, UCLBrusselsBelgium

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