Diagnosis is made histologically and endoscopically. The differential diagnosis includes inflammatory bowel disease, infectious colitis, NSAID-induced colitis, and ischemic colitis, which can usually be distinguished based upon the clinical context. However, distinction from IBD may not always be straightforward particularly since the histologic features of IBD (such as neutrophilic cryptitis, crypt abscesses and distorted crypt architecture) may all be present. Evidence of Crohn's disease elsewhere in the gastrointestinal tract can provide an important clue.
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