According to statistics, 10 to 15 percent of people with chronic inflammatory bowel disease do not receive a clear diagnosis.
It is true that ulcerative colitis or Crohn's disease can sometimes be detected years later. Nevertheless, around one in 10 cases remains undiagnosed. Doctors summarize this under the term indeterminate colitis.
Indeterminate colitis shares many symptoms with other chronic inflammatory bowel diseases (ulcerative colitis or Crohn's disease).
These include the following symptoms in particular:
- Diarrhea, also with an admixture of blood
- Painful bowel movements (tenesmus)
- Extraintestinal symptoms, such as arthritis
- Non-specific symptoms such as fever or a general feeling of illness
Chronic inflammatorybowel disease causes inflammation of the bowel @ Sebastian Kaulitzki /AdobeStock
Indeterminate colitis is a diagnosis of exclusion. This means that doctors only make the diagnosis if they find no other disease despite extensive diagnostics.
Other diseases can be
A range of modern diagnostic procedures are available for diagnosis:
If the results indicate a chronic inflammatory bowel disease, doctors can use the findings to differentiate between Crohn's disease and ulcerative colitis:
- If inflammatory lesions are found in the small intestine, Crohn's disease may be present.
- However, if the inflammation of the intestinal mucosa is limited to the large intestine (colon), it is probably ulcerative colitis.
- If it is not possible to clearly assign one of these two diseases, indeterminate colitis is diagnosed.
As indeterminate colitis is an immune disease in the broader sense, doctors treat it with immunosuppressants.
Steroids are often used for this purpose. In addition, new drugs are also available that are also suitable.
These include
- Infliximab
- tacrolimus or
- 6-thioguanine
Surgical interventions play a minor role in indeterminate colitis and are rarely used.
However, experience shows that some patients develop signs of Crohn's disease or ulcerative colitis even years after the initial diagnosis. This fact makes targeted therapy possible.
The prognosis of the disease is essentially the same as for other chronic inflammatory bowel diseases. Although indeterminate colitis cannot be cured, there are very good treatment options to reduce the symptoms.
Like other chronic inflammatory bowel diseases, indeterminate colitis also belongs to the field of gastroenterology and visceral surgery. Indeterminate colitis specialists work primarily at specialized gastroenterology centers.
Please refer to the list above to find a colitis indeterminata specialist in your area.