Our Summary

This review article talks about the difficulties in diagnosing inflammatory bowel disease (IBD), a condition that causes inflammation in the digestive tract, through biopsy and other methods. It’s important to differentiate IBD from other conditions that may look similar but are caused by infection or other factors. Often, it’s easy to diagnose IBD when patients show typical symptoms and results from lab tests. Knowing a patient’s full medical history is also crucial. All potential IBD cases should be discussed by a team of different specialists so that they can consider all of the patient’s clinical, radiological, and pathological information. The conditions that can be mistaken for IBD fall into four categories: ones due to specific infections, ones from specific localized inflammation, ones caused by medical treatment, and other rare causes. It’s essential to correctly diagnose IBD and rule out these other conditions for proper patient treatment. Once a pathologist suggests a diagnosis of IBD, it’s hard to reverse it, even if another condition is found later on. The article goes into detail about how to diagnose each IBD look-alike condition and gives advice on how to avoid missing these sometimes very subtle and hard-to-diagnose conditions.

FAQs

  1. What makes diagnosing inflammatory bowel disease (IBD) difficult?
  2. Why is it important to differentiate IBD from other conditions that may look similar?
  3. What are the four categories of conditions that can be mistaken for IBD?

Doctor’s Tip

One helpful tip a doctor might tell a patient about bowel resection is to follow all pre-operative instructions provided by the medical team. This may include fasting before the surgery, taking certain medications, and preparing the bowel as directed. Following these instructions can help reduce the risk of complications during the procedure and improve the overall outcome of the surgery. Additionally, it’s important to communicate any concerns or questions with the healthcare team and to have a clear understanding of what to expect before, during, and after the bowel resection.

Suitable For

Patients who are typically recommended for bowel resection are those who have severe complications of inflammatory bowel disease (IBD) such as severe inflammation, strictures, fistulas, abscesses, or perforation. Other conditions that may warrant bowel resection include colorectal cancer, diverticulitis, gastrointestinal bleeding, and bowel obstruction. Additionally, patients who have not responded to conservative treatments such as medication or dietary changes may also be considered for bowel resection. Ultimately, the decision to recommend bowel resection is made on a case-by-case basis by a team of healthcare professionals based on the individual patient’s condition and medical history.

Timeline

Before bowel resection:

  • Patient may experience symptoms such as abdominal pain, diarrhea, bloody stools, weight loss, and fatigue
  • Patient undergoes diagnostic tests such as blood tests, colonoscopy, CT scan, and MRI to confirm the diagnosis of a bowel condition requiring surgery
  • Patient consults with a surgeon to discuss the need for bowel resection and potential risks and benefits of the procedure
  • Patient undergoes pre-operative preparation such as bowel cleansing and fasting

After bowel resection:

  • Patient undergoes surgery to remove the affected portion of the bowel
  • Patient is closely monitored in the hospital for any complications such as infection or bleeding
  • Patient gradually resumes eating and drinking, starting with clear liquids and advancing to solid foods
  • Patient may experience temporary changes in bowel habits and may require medication for pain management
  • Patient is discharged from the hospital once they are able to tolerate food and drink and their pain is well-controlled
  • Patient follows up with their surgeon for post-operative care and monitoring of their recovery

What to Ask Your Doctor

  1. Can you explain to me the reasons why a bowel resection may be necessary for my condition?
  2. What are the potential risks and complications associated with bowel resection surgery?
  3. What is the expected recovery time and rehabilitation process after bowel resection surgery?
  4. Will I need to make any changes to my diet or lifestyle after the surgery?
  5. Are there any alternative treatments or options to consider before undergoing bowel resection surgery?
  6. How will bowel resection surgery affect my long-term digestive health and functioning?
  7. Can you provide me with information on the specific surgical technique that will be used for my bowel resection?
  8. What are the success rates and potential outcomes of bowel resection surgery for my particular condition?
  9. How often will I need to follow up with you or a specialist after the surgery?
  10. Are there any specific warning signs or symptoms I should watch out for after the surgery that may indicate complications or issues?

Reference

Authors: Schofield JB, Haboubi N. Journal: Inflamm Bowel Dis. 2020 Jun 18;26(7):994-1009. doi: 10.1093/ibd/izz232. PMID: 31599934