Inflammatory Bowel Disease

The causes of inflammatory bowel disease (IBD) continue to be an enigma. The incidence has stabilized in Western countries. Involvement of the upper gastrointestinal tract has been found in a high percentage of patients, and can be used to guide the work-up in patients with abdominal complaints. Ileoscopy must be added to the routine investigation when a suspicion of IBD exists. A number of new methods have been proposed, in particular Doppler sonography and magnifying chromoscopy, but their clinical contribution remains to be determined. Carcinoma surveillance is still the major diagnostic problem. New methods are available but need to be evaluated, particularly in patients at increased risk, such as those with primary sclerosing "cholangitis.