1. Mimics of IBD Sunanda Kane MD MSPH Mayo Clinic Rochester

2. Mimics of IBD Discrimination based on: –Location –Symptoms (including EIM) –Endoscopic appearance –Radiographic appearance

3. sgi Diagnostic

4. AntibodyAntigenNon-IBD (%)CD (%)UC (%) ASCA Anti- Saccharomyces cerevisiae antibody 5% 55  65% 5% DNase Sensitive pANCA Histone H1, bacterial antigen? <5% 10  25%50  65% OmpCE. coli<5% 38  50% 2% IBD-Specific Serologic Immune Markers

5. Mimics in Esophagus HSV infection HIV ulcers Pill esophagitis

7. Colonic Ulceration: Crohn’s?

8. Right sided Colonic Thickening: Crohn’s?

9. MRE of Woman with EN and Abdominal Pain Normal!

10. Small Bowel Mimics TB, Yersinia Neoplasm Drugs- NSAIDs, SARBs Celiac Autoimmune enteritis NOS Meckel’s diverticulum Endometriosis

11. Colon Mimics Prep effect Normal colon Histo, CMV, C diff Neoplasm- Kaposi’s sarcoma, leukemia SRUS Drugs-ipilimumab SCAD

12. Either Location Radiation Neoplasm IBS Bechet’s Ischemia

13. Perianal Mimics Trauma: obstetric or GI surgery Infection: TB, LGV Ischemia Neoplasm

14. Small Bowel Obstruction in CD Patient

15. Patient with Crohn’s and Pain

16. Patient with Crohn’s and Continued Weight Loss

17. Mimics of IBD Consider alternative when high dose prednisone does not work Always think about infection, ischemia or neoplastic process Conditions can overlap, can have two entities at once