Classification of pediatric inflammatory bowel disease

Abstract

The correct classification of a patient with inflammatory bowel disease requires careful attention to detail. Patients presenting with signs and symptoms that suggest IBD need to be evaluated in full with a physical examination, supportive laboratory testing, stool cultures, radiographic studies, and endoscopy. If feasible, we recommend upper GI series with small bowel follow through, upper endoscopy, and colonoscopy at the time of disease onset. Two or three biopsies should be taken from each region of the bowel, and given to the pathologist, with a careful endoscopic description that will allow correlation of endoscopy and histology. Patients with colitis and nonspecific findings such as gastritis and backwash ileitis can still have ulcerative colitis. Criteria from the Porto and Montreal groups will help reduce inter-observer variability. Additional research involving imaging, capsule endoscopy, serology, and genetics may prove helpful in the future. However, in 2007, the cornerstone of IBD classification is careful endoscopic evaluation and microsopic examination of biopsied tissue. © 2008 Springer Science+Business Media, LLC. All rights reserved.