Inflammatory bowel disease (IBD) in children and adolescents presents itself mainly as ulcerative colitis and Crohn's disease. The precise aetiology and pathogenesis of the disease is not completely ...understood. The diagnosis of IBDis based on the clinical picture as well as laboratory data, imaging procedures, and endoscopic evaluation with histological examination of biopsy specimens. Ulcerative colitis and Crohn's disease have several distinguishing features. Ulcerative colitis only affects the large intestine, whereas Crohn'sdisease can affect any part of the digestive tract. The clinical picture is determined by the localization, extent and duration of the disease.Patients with a severe form of the disease always present with systemic signs. Extraintestinal involvement is commonly associated with IBD. The gold standard for the diagnosis of IBD is endoscopic evaluation of the digestive tract with its ability to directly visualize any mucosal changes. Endoscopy also permits multiple biopsies to be obtained for histological evaluation. Imaging procedures, including ultrasound (US), scintigraphy, contrast studies, computerized tomography (CT) and magnetic resonance imaging (MRI) are important in diagnosing IBD. Newer diagnostic procedures in IBD include immunological and genetic testing. Establishing a firm diagnosis of IBD is not only important diagnostically, but also enables the most successfultherapy to be selected, and the most appropriate follow-up regime tobe determined.
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