{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T08:28:36Z","timestamp":1787300916985,"version":"build-2736575974"},"reference-count":202,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Vanderbilt Clinical and Translational Science Award","award":["UL1 RR024975-01"],"award-info":[{"award-number":["UL1 RR024975-01"]}]},{"DOI":"10.13039\/100000048","name":"American Cancer Society","doi-asserted-by":"crossref","award":["DICRIDG-21-071-01-DICRIDG"],"award-info":[{"award-number":["DICRIDG-21-071-01-DICRIDG"]}],"id":[{"id":"10.13039\/100000048","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Vanderbilt-Ingram Cancer Center Specialized Program of Research Excellence (SPORE) in Gastrointestinal Cancer","award":["P50CA236733"],"award-info":[{"award-number":["P50CA236733"]}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"crossref","award":["U54MD007586"],"award-info":[{"award-number":["U54MD007586"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100005930","name":"Research Foundation of the American Society of Colon and Rectal Surgeons","doi-asserted-by":"crossref","award":["LPG086"],"award-info":[{"award-number":["LPG086"]}],"id":[{"id":"10.13039\/100005930","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["5P30 DK58404-08\/RR\/NCRR, U54MD007586-37, and D34HP"],"award-info":[{"award-number":["5P30 DK58404-08\/RR\/NCRR, U54MD007586-37, and D34HP"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Colorectal inflammatory bowel disease (cIBD) encompasses the colitides\u2014ulcerative colitis (UC) and Crohn\u2019s colitis (CC)\u2014and is defined by chronic, relapsing inflammation of the colon and rectum. Indeterminate colitis (IC) is diagnosed when available clinical and diagnostic features do not allow clear classification as UC or CC. cIBD is increasingly recognized as a global disease; however, in Sub-Saharan Africa (SSA), it is often misdiagnosed within an infectious-disease\u2013dominant clinical environment, under conditions of constrained diagnostic infrastructure and unmet management needs. In this overview, we summarize the current state of the cIBD landscape in SSA, detailing limitations related to diagnostic misclassification, systemic-level constraints, and management challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive literature review was conducted from 1997 to 2026 using a multipronged search strategy guided by a prespecified protocol consistent with the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Electronic searches were conducted in MEDLINE (via PubMed), Current Nursing, Excerpta Medica Database (EMBASE), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, the Cochrane Library, and the Google\u00ae search engine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across Africa, a total of 268 studies have been identified, with SSA contributing only a minority. Among publications from 2024 to 2026, 175 were case reports. Overall, 1953 documented cases of cIBD were reported across 34 publications spanning 1997 to 2026, with the majority originating from South Africa. Ulcerative colitis (UC) accounted for most reported cases, while the remaining literature primarily consisted of isolated case reports or small case series. Ghana and Nigeria have shown a marked increase in reported cases of cIBD over time. A retrospective analysis covering 1997 to 2026 identified 45 cases, reflecting approximately a 65% rise in case detection at Korle-Bu Teaching Hospital in Accra, Ghana. The largest data set was from Nigeria, comprising 459 suspected cases and 208 histologically confirmed cIBD patients collected from 18 centers. The scarcity and limited transparency of data regarding the current state of cIBD reflect persistent challenges, such as low disease awareness, diagnostic limitations, underdiagnosis, underreporting, the lack of dedicated cIBD registries, and a shortage of specialized health care professionals. Significant gaps persist in diagnostic infrastructure, including inadequately equipped laboratories and limited clinical capacity for managing cIBD. Notably, cIBD in sub-Saharan Africa appears to affect a younger demographic, and high rates of misdiagnosis persist due to the similarity of symptoms with infectious and parasitic diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Emerging evidence indicates that the incidence and prevalence of cIBD in SSA are increasing. Significant challenges persist, including diagnostic misclassification and misdiagnosis within a parasitic and infectious-colitides\u2013dominant clinical environment, under conditions of constrained diagnostic infrastructure. These challenges are further exacerbated by inadequate endoscopic, pathological, and laboratory capacities within health care systems. Shortages in personnel, equipment, infrastructure, and funding constitute significant barriers. Addressing these deficiencies necessitates the development of context-specific diagnostic algorithms, the expansion of laboratory and endoscopic facilities, targeted clinician training, and the implementation of integrated care pathways that facilitate the simultaneous assessment of infectious and inflammatory etiologies of colitis. Currently, the literature on cIBD from SSA remains scarce.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261471491","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:59:13Z","timestamp":1787025553000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Colorectal Inflammatory Bowel Disease in Sub-Saharan Africa: Diagnostic Challenges and Systemic Care Constraints"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1728-8456","authenticated-orcid":false,"given":"Amosy E.","family":"M\u2019Koma","sequence":"first","affiliation":[{"name":"Meharry Medical College School of Medicine"},{"name":"Meharry Medical College School of Medicine"},{"name":"Vanderbilt University Medical Center School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6196-440X","authenticated-orcid":false,"given":"Shaneeta M.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Meharry Medical College School of Medicine"},{"name":"Meharry School of Global Health"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2023.04.003"},{"key":"e_1_3_6_3_2","doi-asserted-by":"crossref","first-page":"e065186","DOI":"10.1136\/bmjopen-2022-065186","article-title":"Global, regional and national burden of inflammatory bowel disease in 204 countries and territories from 1990 to 2019: a systematic analysis based on the global burden of disease Study 2019","volume":"13","author":"Wang R","year":"2023","unstructured":"Wang R, Li Z, Liu S, Zhang D. Global, regional and national burden of inflammatory bowel disease in 204 countries and territories from 1990 to 2019: a systematic analysis based on the global burden of disease Study 2019. BMJ Open. 2023;13:e065186.","journal-title":"BMJ Open"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-17431-8"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v29.i42.5751"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/gastro\/goae053"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.2020.v110i10.14489"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/inthealth\/ihaa005"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(23)00396-5"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2017.88"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(22)00048-6"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/17562848231184986"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjae082"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0340892"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/ueg2.70075"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-025-04821-0"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-025-01063-x"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-025-08940-0"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14238390"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32448-0"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000003868"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-025-01097-1"},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v12.i38.6102"},{"key":"e_1_3_6_24_2","volume-title":"Familial Polyposis Coli: Family Studies, Histopathology, Differentially Diagnosis and Results of Treatment","year":"1975","unstructured":"Familial Polyposis Coli: Family Studies, Histopathology, Differentially Diagnosis and Results of Treatment. The John Hopkins University Press; 1975."},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.4137\/CGast.S12731"},{"key":"e_1_3_6_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15587"},{"key":"e_1_3_6_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)32126-2"},{"key":"e_1_3_6_28_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2011.10.001"},{"key":"e_1_3_6_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0000000000000364"},{"key":"e_1_3_6_30_2","doi-asserted-by":"publisher","DOI":"10.4414\/smw.2018.14599"},{"key":"e_1_3_6_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31711-1"},{"key":"e_1_3_6_32_2","doi-asserted-by":"publisher","DOI":"10.3390\/gidisord1010007"},{"key":"e_1_3_6_33_2","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/8201672"},{"key":"e_1_3_6_34_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines13020305"},{"key":"e_1_3_6_35_2","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.21145"},{"key":"e_1_3_6_36_2","doi-asserted-by":"publisher","DOI":"10.1097\/MS9.0000000000003141"},{"key":"e_1_3_6_37_2","doi-asserted-by":"publisher","DOI":"10.1200\/JGO.19.00301"},{"key":"e_1_3_6_38_2","first-page":"386","article-title":"[A rare association of Takayasu's disease and inflammatory bowel disease in Gabon]","volume":"3","author":"Iba Ba J","year":"2023","unstructured":"Iba Ba J, Mfoumou AF, Mbounja M, et al. [A rare association of Takayasu's disease and inflammatory bowel disease in Gabon]. Med Trop Sante Int. 2023;3:386.","journal-title":"Med Trop Sante Int"},{"key":"e_1_3_6_39_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.epirev.a036298"},{"key":"e_1_3_6_40_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_3_6_41_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g7647"},{"key":"e_1_3_6_42_2","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjae126"},{"key":"e_1_3_6_43_2","doi-asserted-by":"publisher","DOI":"10.1080\/20469047.2020.1787020"},{"key":"e_1_3_6_44_2","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.2024.v114i4.1667"},{"key":"e_1_3_6_45_2","doi-asserted-by":"publisher","DOI":"10.17159\/2078-5151\/2021\/v59n4a3190"},{"key":"e_1_3_6_46_2","first-page":"40","article-title":"Inflammatory bowel disease in accra: what new trends","volume":"32","author":"Archampong TN","year":"2013","unstructured":"Archampong TN, Nkrumah KN. Inflammatory bowel disease in accra: what new trends. W Afr J Med. 2013;32:40-44.","journal-title":"W Afr J Med"},{"key":"e_1_3_6_47_2","first-page":"187","article-title":"Unmasking inflammatory bowel disease in Nigeria: a multicenter cross-sectional analysis of clinico-pathological and endoscopic findings","volume":"3","author":"Musa Y","year":"2025","unstructured":"Musa Y. Unmasking inflammatory bowel disease in Nigeria: a multicenter cross-sectional analysis of clinico-pathological and endoscopic findings. Journal of Translational Gastroenterology. 2025;3:187-196.","journal-title":"Journal of Translational Gastroenterology"},{"key":"e_1_3_6_48_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-020-00360-x"},{"key":"e_1_3_6_49_2","first-page":"132","article-title":"Global prevalence and incidence of inflammatory bowel disease: a systematic review and meta-analysis of population-based studies","volume":"18","author":"Heydari K","year":"2025","unstructured":"Heydari K, Rahnavard M, Ghahramani S, et al. Global prevalence and incidence of inflammatory bowel disease: a systematic review and meta-analysis of population-based studies. Gastroenterol Hepatol Bed Bench. 2025;18:132-146.","journal-title":"Gastroenterol Hepatol Bed Bench"},{"key":"e_1_3_6_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(22)00047-4"},{"key":"e_1_3_6_51_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-039456"},{"key":"e_1_3_6_52_2","first-page":"172","article-title":"Inflammatory bowel disease in rural Sub-Saharan Africa: rarity of diagnosis in patients attending mission hospitals","volume":"44","author":"Mayberry J","year":"1989","unstructured":"Mayberry J, Mann R. Inflammatory bowel disease in rural Sub-Saharan Africa: rarity of diagnosis in patients attending mission hospitals. Digestion. 1989;44:172-176.","journal-title":"Digestion"},{"key":"e_1_3_6_53_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2025-103432"},{"key":"e_1_3_6_54_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000047168"},{"key":"e_1_3_6_55_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(23)00368-0"},{"key":"e_1_3_6_56_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-025-24009-z"},{"key":"e_1_3_6_57_2","doi-asserted-by":"publisher","DOI":"10.3389\/fragi.2024.1479928"},{"key":"e_1_3_6_58_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.0595"},{"key":"e_1_3_6_59_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2025.1670440"},{"key":"e_1_3_6_60_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjnph-2024-001098"},{"key":"e_1_3_6_61_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2024.12.036"},{"key":"e_1_3_6_62_2","doi-asserted-by":"publisher","DOI":"10.1055\/a-1551-3343"},{"key":"e_1_3_6_63_2","first-page":"194","article-title":"Presentation and management outcome of inflammatory bowel disease in Sudan","volume":"26","author":"Khalifa SE","year":"2005","unstructured":"Khalifa SE, Mudawi HM, Fedail SS. Presentation and management outcome of inflammatory bowel disease in Sudan. Trop Gastroenterol. 2005;26:194-196.","journal-title":"Trop Gastroenterol"},{"key":"e_1_3_6_64_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-020-08174-3"},{"key":"e_1_3_6_65_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-016-0304-7"},{"key":"e_1_3_6_66_2","doi-asserted-by":"publisher","DOI":"10.3390\/pharmacy7020040"},{"key":"e_1_3_6_67_2","first-page":"e5689","article-title":"Intestinal tuberculosis and Crohn's disease is always a diagnostic challenge: a case report and review of the literature on the importance of fecal mycobacterial cultures and the limitations of latent infection testing","volume":"11","author":"Kurnick A","year":"2019","unstructured":"Kurnick A, Bar N, Maharshak N. Intestinal tuberculosis and Crohn's disease is always a diagnostic challenge: a case report and review of the literature on the importance of fecal mycobacterial cultures and the limitations of latent infection testing. Cureus. 2019;11:e5689.","journal-title":"Cureus"},{"key":"e_1_3_6_68_2","first-page":"1510236","article-title":"An unusual presentation of disseminated tuberculosis in south-west Nigeria: a case report","volume":"236","author":"Emuze MEEA","year":"2021","unstructured":"Emuze MEEA, Olalusi O, Adegoke OO, Ogunsanya TE, Akunwata C, Akulue J. An unusual presentation of disseminated tuberculosis in south-west Nigeria: a case report. J Infect Dis Epidemiol. 2021;236:1510236.","journal-title":"J Infect Dis Epidemiol"},{"key":"e_1_3_6_69_2","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.2361-18"},{"key":"e_1_3_6_70_2","doi-asserted-by":"publisher","DOI":"10.38179\/ijcr.v1i1.2"},{"key":"e_1_3_6_71_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40064-015-1129-x"},{"key":"e_1_3_6_72_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radcr.2023.07.035"},{"key":"e_1_3_6_73_2","first-page":"e50002","article-title":"Disseminated miliary and intestinal tuberculosis mimicking inflammatory bowel disease","volume":"15","author":"Tran D","year":"2023","unstructured":"Tran D, Patel K, Ashfaq A, Lyons B. Disseminated miliary and intestinal tuberculosis mimicking inflammatory bowel disease. Cureus. 2023;15:e50002.","journal-title":"Cureus"},{"key":"e_1_3_6_74_2","first-page":"7312630","article-title":"Disseminated tuberculosis mimicking as crohn's disease in a paediatric patient","volume":"2023","author":"Feenstra E","year":"2023","unstructured":"Feenstra E, Driesen Y, Moes N, Jouret N, Vanden Driessche K. Disseminated tuberculosis mimicking as crohn's disease in a paediatric patient. Case Rep Infect Dis. 2023;2023:7312630-7312634.","journal-title":"Case Rep Infect Dis"},{"key":"e_1_3_6_75_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-023-02887-0"},{"key":"e_1_3_6_76_2","doi-asserted-by":"publisher","DOI":"10.1177\/17562848241265013"},{"key":"e_1_3_6_77_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmni.2024.101533"},{"key":"e_1_3_6_78_2","doi-asserted-by":"publisher","DOI":"10.1111\/1751-2980.13206"},{"key":"e_1_3_6_79_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1108119"},{"key":"e_1_3_6_80_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgast-2025-002080"},{"key":"e_1_3_6_81_2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina62040794"},{"key":"e_1_3_6_82_2","first-page":"e86866","article-title":"Intestinal amoebiasis associated with inflammatory bowel diseases: an eight-year retrospective study at Ibn Sina university hospital, Rabat, Morocco (2014-2022)","volume":"17","author":"Lfaquir FZ","year":"2025","unstructured":"Lfaquir FZ, Zouaoui I, Zimi K, Aoufi S. Intestinal amoebiasis associated with inflammatory bowel diseases: an eight-year retrospective study at Ibn Sina university hospital, Rabat, Morocco (2014-2022). Cureus. 2025;17:e86866.","journal-title":"Cureus"},{"key":"e_1_3_6_83_2","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.5609"},{"key":"e_1_3_6_84_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40792-022-01568-6"},{"key":"e_1_3_6_85_2","first-page":"100","article-title":"Microscopic colitis: a review of the literature and histopathologic mimickers","volume":"3","author":"Miller APC","year":"2025","unstructured":"Miller APC, Hu J. Microscopic colitis: a review of the literature and histopathologic mimickers. Journal of Translational Gastroenterology. 2025;3:100-107.","journal-title":"Journal of Translational Gastroenterology"},{"key":"e_1_3_6_86_2","first-page":"556072","article-title":"When it\u2019s not IBD: a clinician\u2019s map through the mimic maze","volume":"21","author":"Ilyas RCA","year":"2025","unstructured":"Ilyas RCA, Elsayed MOK, Talkhan M. When it\u2019s not IBD: a clinician\u2019s map through the mimic maze. Advanced Research in Gastroenterology and Hepatology. 2025;21:556072.","journal-title":"Advanced Research in Gastroenterology and Hepatology"},{"key":"e_1_3_6_87_2","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro-2019-101204"},{"key":"e_1_3_6_88_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i44.8042"},{"key":"e_1_3_6_89_2","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjac156"},{"key":"e_1_3_6_90_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-024-04436-z"},{"key":"e_1_3_6_91_2","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izae020.162"},{"key":"e_1_3_6_92_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-024-04748-y"},{"key":"e_1_3_6_93_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm15020646"},{"key":"e_1_3_6_94_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12186084"},{"key":"e_1_3_6_95_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-023-00871-y"},{"key":"e_1_3_6_96_2","doi-asserted-by":"publisher","DOI":"10.1093\/crocol\/otae022"},{"key":"e_1_3_6_97_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gastha.2024.06.002"},{"key":"e_1_3_6_98_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-021-00273-2"},{"key":"e_1_3_6_99_2","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.79397"},{"key":"e_1_3_6_100_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-023-01094-6"},{"key":"e_1_3_6_101_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.727412"},{"key":"e_1_3_6_102_2","doi-asserted-by":"publisher","DOI":"10.22551\/2023.41.1004.10271"},{"key":"e_1_3_6_103_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0000000000000896"},{"key":"e_1_3_6_104_2","first-page":"299","article-title":"Pathophysiology of non-esophageal eosinophilic gastrointestinal disorders","volume":"44","author":"Dunn JLM","year":"2024","unstructured":"Dunn JLM, Spencer LA. Pathophysiology of non-esophageal eosinophilic gastrointestinal disorders. Immunol Allergy Clin. 2024;44:299-309.","journal-title":"Immunol Allergy Clin"},{"key":"e_1_3_6_105_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2022.05.012"},{"key":"e_1_3_6_106_2","volume-title":"Behcet disease","author":"Adil A","year":"2026","unstructured":"Adil A, Goyal A, Quint JM. Behcet disease. StatPearls; 2026."},{"key":"e_1_3_6_107_2","first-page":"103","article-title":"Mimicry and deception in inflammatory bowel disease and intestinal Behcet disease","volume":"8","author":"Grigg EL","year":"2012","unstructured":"Grigg EL, Kane S, Katz S. Mimicry and deception in inflammatory bowel disease and intestinal Behcet disease. Gastroenterol Hepatol. 2012;8:103-112.","journal-title":"Gastroenterol Hepatol"},{"key":"e_1_3_6_108_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24098176"},{"key":"e_1_3_6_109_2","doi-asserted-by":"publisher","DOI":"10.1159\/000520696"},{"key":"e_1_3_6_110_2","doi-asserted-by":"publisher","DOI":"10.4253\/wjge.v16.i8.472"},{"key":"e_1_3_6_111_2","first-page":"4843765","article-title":"Anti-DEFA5 monoclonal antibody clones 1A8 and 4F5 immunoreactive bioassay for diagnosing inflammatory bowel disease","volume":"1","author":"Thangaiyan R","year":"2024","unstructured":"Thangaiyan R, Sakwe AM, Hawkins AT, et al. Anti-DEFA5 monoclonal antibody clones 1A8 and 4F5 immunoreactive bioassay for diagnosing inflammatory bowel disease. Res Sq. 2024;1:4843765.","journal-title":"Res Sq"},{"key":"e_1_3_6_112_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0179710"},{"key":"e_1_3_6_113_2","doi-asserted-by":"publisher","DOI":"10.4253\/wjge.v7.i7.670"},{"key":"e_1_3_6_114_2","first-page":"4188","article-title":"Ubiquitous colonic ileal metaplasia consistent with the diagnosis of crohn's colitis among indeterminate colitis cohorts","volume":"11","author":"Breaux WA","year":"2023","unstructured":"Breaux WA, Bragg MA, M'Koma AE. Ubiquitous colonic ileal metaplasia consistent with the diagnosis of crohn's colitis among indeterminate colitis cohorts. Med Res Arch. 2023;11:4188.","journal-title":"Med Res Arch"},{"key":"e_1_3_6_115_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00011-024-01970-w"},{"key":"e_1_3_6_116_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijbiomac.2025.148024"},{"key":"e_1_3_6_117_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-023-04515-5"},{"key":"e_1_3_6_118_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.MIB.0000215093.62245.b9"},{"key":"e_1_3_6_119_2","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2014.131"},{"key":"e_1_3_6_120_2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2003.015214"},{"key":"e_1_3_6_121_2","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S268262"},{"key":"e_1_3_6_122_2","doi-asserted-by":"publisher","DOI":"10.4103\/1117-1936.169543"},{"key":"e_1_3_6_123_2","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/daae114"},{"key":"e_1_3_6_124_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0003433"},{"key":"e_1_3_6_125_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajg.2022.09.001"},{"key":"e_1_3_6_126_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0307705"},{"key":"e_1_3_6_127_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0305469"},{"key":"e_1_3_6_128_2","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2014.19.119.3575"},{"key":"e_1_3_6_129_2","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.14022"},{"key":"e_1_3_6_130_2","first-page":"6626","article-title":"Intestinal tuberculosis or Crohn\u2019s disease: a review of the diagnostic challenges","volume":"23","author":"Limsrivilai JPN","year":"2017","unstructured":"Limsrivilai JPN. Intestinal tuberculosis or Crohn\u2019s disease: a review of the diagnostic challenges. World J Gastroenterol. 2017;23:6626-6633.","journal-title":"World J Gastroenterol"},{"key":"e_1_3_6_131_2","doi-asserted-by":"publisher","DOI":"10.4103\/jwas.jwas_126_23"},{"key":"e_1_3_6_132_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41419-018-0982-2"},{"key":"e_1_3_6_133_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.12.014"},{"key":"e_1_3_6_134_2","first-page":"124","article-title":"Amoebic colitis masquerading as inflammatory bowel disease for a decade","volume":"136","author":"Honap S","year":"2023","unstructured":"Honap S, Anderson S. Amoebic colitis masquerading as inflammatory bowel disease for a decade. N Z Med J. 2023;136:124-127.","journal-title":"N Z Med J"},{"key":"e_1_3_6_135_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12865-024-00614-2"},{"key":"e_1_3_6_136_2","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens13100906"},{"key":"e_1_3_6_137_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.1013779"},{"key":"e_1_3_6_138_2","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14956"},{"key":"e_1_3_6_139_2","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12141"},{"key":"e_1_3_6_140_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(21)00275-2"},{"key":"e_1_3_6_141_2","doi-asserted-by":"publisher","DOI":"10.1177\/17562848251383792"},{"key":"e_1_3_6_142_2","first-page":"1165","article-title":"Inflammatory bowel disease On-Line web-based guide to health professionals and patients in developing and African nations","volume":"3","author":"Herman AM","year":"2020","unstructured":"Herman AM, Hawkins AT, James SD, Ballard BR, M'Koma AE. Inflammatory bowel disease On-Line web-based guide to health professionals and patients in developing and African nations. Jpn J Gastroenterol Hepatol. 2020;3:1165.","journal-title":"Jpn J Gastroenterol Hepatol"},{"key":"e_1_3_6_143_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2024.07.014"},{"key":"e_1_3_6_144_2","doi-asserted-by":"publisher","DOI":"10.1097\/MS9.0000000000004075"},{"key":"e_1_3_6_145_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-024-03385-7"},{"key":"e_1_3_6_146_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-024-03468-5"},{"key":"e_1_3_6_147_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-024-03187-x"},{"key":"e_1_3_6_148_2","doi-asserted-by":"publisher","DOI":"10.1093\/crocol\/otad067"},{"key":"e_1_3_6_149_2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina59071254"},{"key":"e_1_3_6_150_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2005.00287.x"},{"key":"e_1_3_6_151_2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.48.4.526"},{"key":"e_1_3_6_152_2","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjaa089"},{"key":"e_1_3_6_153_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-019-1926-2"},{"key":"e_1_3_6_154_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15164154"},{"key":"e_1_3_6_155_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15082389"},{"key":"e_1_3_6_156_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41389-023-00492-0"},{"key":"e_1_3_6_157_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.10.035"},{"key":"e_1_3_6_158_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.09.047"},{"key":"e_1_3_6_159_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.05.063"},{"key":"e_1_3_6_160_2","doi-asserted-by":"publisher","DOI":"10.36518\/2689-0216.2259"},{"key":"e_1_3_6_161_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2304714"},{"key":"e_1_3_6_162_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-011-1137-4"},{"key":"e_1_3_6_163_2","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izad112"},{"key":"e_1_3_6_164_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-010-0664-2"},{"key":"e_1_3_6_165_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(22)00039-5"},{"key":"e_1_3_6_166_2","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002348"},{"key":"e_1_3_6_167_2","doi-asserted-by":"publisher","DOI":"10.1111\/codi.16996"},{"key":"e_1_3_6_168_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-019-0679-4"},{"key":"e_1_3_6_169_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11030866"},{"key":"e_1_3_6_170_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2018-316191"},{"key":"e_1_3_6_171_2","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2015.65"},{"key":"e_1_3_6_172_2","doi-asserted-by":"publisher","DOI":"10.1023\/B:DDAS.0000042242.22898.d9"},{"key":"e_1_3_6_173_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2018.05.017"},{"key":"e_1_3_6_174_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i44.16389"},{"key":"e_1_3_6_175_2","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000002514"},{"key":"e_1_3_6_176_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-025-01078-4"},{"key":"e_1_3_6_177_2","doi-asserted-by":"publisher","DOI":"10.3389\/fgwh.2025.1580451"},{"key":"e_1_3_6_178_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(24)00439-4"},{"key":"e_1_3_6_179_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2024.12.016"},{"key":"e_1_3_6_180_2","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14557"},{"key":"e_1_3_6_181_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2010.04.022"},{"key":"e_1_3_6_182_2","doi-asserted-by":"publisher","DOI":"10.4314\/mmj.v32i3.6"},{"key":"e_1_3_6_183_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(19)30358-9"},{"key":"e_1_3_6_184_2","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjz180"},{"key":"e_1_3_6_185_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11938-018-0177-z"},{"key":"e_1_3_6_186_2","first-page":"904","article-title":"Strategies for overcoming barriers to adopting biosimilars and achieving goals of the biologics price competition and innovation act: a survey of managed care and specialty pharmacy professionals","volume":"25","author":"Greene L","year":"2019","unstructured":"Greene L, Singh RM, Carden MJ, Pardo CO, Lichtenstein GR. Strategies for overcoming barriers to adopting biosimilars and achieving goals of the biologics price competition and innovation act: a survey of managed care and specialty pharmacy professionals. J Manag Care Spec Pharm. 2019;25:904-912.","journal-title":"J Manag Care Spec Pharm"},{"key":"e_1_3_6_187_2","doi-asserted-by":"publisher","DOI":"10.5217\/ir.2019.09147"},{"key":"e_1_3_6_188_2","doi-asserted-by":"publisher","DOI":"10.2174\/0929867324666170406112304"},{"key":"e_1_3_6_189_2","doi-asserted-by":"publisher","DOI":"10.2174\/1381612825666190312112900"},{"key":"e_1_3_6_190_2","unstructured":"dr. https:\/\/www.mnh.or.tz"},{"key":"e_1_3_6_191_2","doi-asserted-by":"publisher","DOI":"10.4103\/njcp.njcp_341_20"},{"key":"e_1_3_6_192_2","doi-asserted-by":"publisher","DOI":"10.4314\/mmj.v30i1.4"},{"key":"e_1_3_6_193_2","first-page":"33","article-title":"Endoscopic evaluation of the colorectum in patients presenting with haematochezia at Korle-Bu teaching hospital accra","volume":"42","author":"Dakubo JCB","year":"2008","unstructured":"Dakubo JCB, Kumoji R, Naaeder SB, Clegg-Lamptey JN. Endoscopic evaluation of the colorectum in patients presenting with haematochezia at Korle-Bu teaching hospital accra. Ghana Med J. 2008;42:33-37.","journal-title":"Ghana Med J"},{"key":"e_1_3_6_194_2","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2018.29.178.10785"},{"key":"e_1_3_6_195_2","doi-asserted-by":"publisher","DOI":"10.4236\/ojgas.2021.119017"},{"key":"e_1_3_6_196_2","doi-asserted-by":"publisher","DOI":"10.4103\/njcp.njcp_497_20"},{"key":"e_1_3_6_197_2","first-page":"540","article-title":"Colonoscopic findings in Kenyan African patients","volume":"75","author":"Ogutu EO","year":"1998","unstructured":"Ogutu EO, Okoth FA, Lule GN. Colonoscopic findings in Kenyan African patients. East Afr Med J. 1998;75:540-543.","journal-title":"East Afr Med J"},{"key":"e_1_3_6_198_2","author":"X Rayted Stock Photos and Pictures Stock Photos and Pictures-Science Photo Library","unstructured":"X Rayted Stock Photos and Pictures Stock Photos and Pictures-Science Photo Library. Science Photo Library (SPL), 87 Lancaster Road. London W11 1QQ, UK. https:\/\/www.sciencephoto.com\/set\/3581\/x-rayted","journal-title":"Science Photo Library (SPL), 87 Lancaster Road"},{"key":"e_1_3_6_199_2","first-page":"885","article-title":"The indications and findings at colonoscopy in a tertiary hospital in north-central Nigeria: a seven-year review","volume":"38","author":"Bojuwoye MO","year":"2021","unstructured":"Bojuwoye MO, Bamidele OF, Okonkwo K, et al. The indications and findings at colonoscopy in a tertiary hospital in north-central Nigeria: a seven-year review. W Afr J Med. 2021;38:885-891.","journal-title":"W Afr J Med"},{"key":"e_1_3_6_200_2","unstructured":"dr. https:\/\/americanafricanhealthteam.com\/"},{"key":"e_1_3_6_201_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2007.03332.x"},{"key":"e_1_3_6_202_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v25.i4.418"},{"key":"e_1_3_6_203_2","doi-asserted-by":"publisher","DOI":"10.4103\/1596-3519.188889"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261471491","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348261471491","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261471491","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T08:22:13Z","timestamp":1787300533000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348261471491"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":202,"alternative-id":["10.1177\/00031348261471491"],"URL":"https:\/\/doi.org\/10.1177\/00031348261471491","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]},"article-number":"00031348261471491"}}