The majority of patients with chronic inflammatory bowel disease (IBD) are diagnosed with either ulcerative colitis or Crohn's disease on the basis of established clinical, endoscopic, histological and radiological criteria.1 However, in 5-23% of patients with chronic colitis, a definitive diagnosis of ulcerative colitis or Crohn's disease cannot be established because the initial colonoscopic and histological features overlap between ulcerative colitis and Crohn's disease.2-6 While the condition of most of these patients eventually evolves into patterns consistent with ulcerative colitis or Crohn's disease, approximately 20-60% retain the diagnosis of indeterminate colitis over periods as long as 5-10 years after the diagnosis.3,5,7-11 This latter observation suggests that indeterminate colitis may constitute a separate category within the spectrum of IBD. This chapter reviews the clinical features of indeterminate colitis, focusing primarily on the pediatric population.

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