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GuidelineIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2026

Histological approach and differentiation of Crohn's disease and gastrointestinal tuberculosis: Recommendations from the joint IAPM-ISG-CCFI Working Group.

Prasenjit Das, Puja Sakhuja, Aminder Singh, Arshdeep Singh, Sagir Akhtar, Saurabh Kedia, Vishal Sharma, Kim Vaiphei, Anna Pulimood, Roopa Rachel Paulose and 23 more

Abstract readPractice Guideline
PubMed Publisher
In one paragraph

Guideline in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

33 authors.

Prasenjit DasDepartment of Pathology, All India Institute of Medical Sciences, New Delhi, 110 029, India. prasenaiims@gmail.com.ORCID http://orcid.org/0000-0002-2420-8573
Puja SakhujaDepartment of Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, 110 002, India.
Aminder SinghDepartment of Pathology, Dayanand Medical College and Hospital, Ludhiana, 141 001, India.
Arshdeep SinghDepartment of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, 141 001, India.
Sagir AkhtarDepartment of Pathology, All India Institute of Medical Sciences, New Delhi, 110 029, India.
Saurabh KediaDepartment of Gastroenterology, All India Institute of Medical Sciences, Gorakhpur, 273 008, India.
Vishal SharmaDepartment of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India.
Kim VaipheiDepartment of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India.
Anna PulimoodDepartment of Pathology, Christian Medical College Vellore, Vellore, 632 004, India.
Roopa Rachel PauloseDepartment of Pathology, Amrita Vishwa Vidyapeetham, Kochi, 682 024, India.
Anuradha SekaranDepartment of Pathology, Asian Institute of Gastroenterology, Hyderabad , 500 032, India.
Sanjeev Vasudev KattiDepartment of Pathology, Columbia Asia Hospital, Bangalore, 560 066, India.
Mala BanerjeeDepartment of Pathology, KPC Medical College and Hospital and Peerless Hospital, Kolkata, 700 032, India.
Ritambhra NadaDepartment of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India.
Nuzhat HussainDepartment of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226 010, India.
Niraj KumariDepartment of Pathology, All India Institute of Medical Sciences, Raebareli, 229 405, India.
Rajni YadavDepartment of Pathology, All India Institute of Medical Sciences, New Delhi, 110 029, India.
Rajib SarkarDepartment of Gastroenterology, School of Digestive and Liver Diseases, IPGMER SSKM Hospital, Kolkata, 700 020, India.
Vatsala MisraDepartment of Pathology, Motilal Nehru Medical College, Allahābād, 211 002, India. drvatsalamisra@gmail.com.ORCID http://orcid.org/0000-0003-1296-1258
Vandana MidhaDepartment of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, 141 001, India.
Uday C GhoshalDepartment of Gastroenterology, Apollo Multispeciality Hospital, Kolkata, 700 054, India.
Amit K DuttaDepartment of Gastroenterology, Christian Medical College, Vellore, 632 004, India.
Rupa BanerjeeDepartment of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, 500 032, India.
Devendra DesaiDepartment of Gastroenterology, P D Hinduja Hospital and Medical Research Centre, Mumbai, 400 016, India.
Ajay KumarInstitute for Digestive and Liver Diseases, Gastroenterology and Hepatology, BLK-Max Super Speciality Hospital, Delhi, 110 005, India.
Sandeep NijhawanDepartment of Gastroenterology, Mahatma Gandhi Medical College and Hospital, Jaipur, 302 022, India.
Mathew PhilipDepartment of Gastroenterology, Lisie Hospital, Cochin, 682 018, India.
Usha DuttaDepartment of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India.
Govind K MakhariaDepartment of Gastroenterology, All India Institute of Medical Sciences, New Delhi, 110 029, India.
Siddhartha Datta GuptaDepartment of Pathology, St Johns Medical College and Hospital, Bangalore, 560 034, India.
B S RamakrishnaDepartment of Gastroenterology, SRM Institutes for Medical Sciences, Chennai , 603 203, India.
Ajit SoodDepartment of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, 141 001, India. ajitsood10@gmail.com.ORCID http://orcid.org/0000-0001-6961-6389
Vineet AhujaDepartment of Gastroenterology, All India Institute of Medical Sciences, New Delhi, 110 029, India. vineet.aiims@gmail.com.ORCID http://orcid.org/0000-0002-1577-0118

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe most common causes for ulcero-stricturing diseases of the ileo-cecal region and colon in Southeast Asia are Crohn's disease (CD) and gastrointestinal tuberculosis (GI TB). Diagnosing these conditions is challenging because they share several clinical, endoscopic, radiological and histological features on mucosal biopsies. Therefore, there is a need to standardize the sampling, processing and interpretation of mucosal biopsies to aid clinical decision-making.

methodsRecognizing this challenge, core subject experts nominated by the Indian Association of Pathologists and Microbiologists (IAPM), the Indian Society of Gastroenterology (ISG) and the Colitis and Crohn's Foundation, India (CCFI), collaborated to formulate comprehensive recommendations for pathologists regarding optimal biopsy protocols, histological interpretation and reporting for differentiating CD from GI TB. A structured Delphi process was followed.

resultsThe recommendations from the core domain expert groups were based on discussions, brainstorming sessions and extensive literature reviews conducted over three virtual group meetings, multiple online voting sessions and one physical meeting involving all experts. This document is expected to standardize the practice of luminal gastroenterology by providing a ready reference for budding specialists and pathologists, thereby promoting uniformity in practice.

conclusionThese multi-society, evidence-based and practically applicable recommendations developed by core subject experts aim to promote uniformity and confidence in pathology reports, facilitate timely patient management and prevent complications arising from erroneous treatment.

Indexed as

Crohn DiseaseGastroenterologyTuberculosis, GastrointestinalBiopsyDelphi TechniqueDiagnosis, DifferentialHumansIndiaSocieties, MedicalCrohn’s diseaseEndoscopic mucosal biopsiesGastrointestinal tuberculosisGranulomasHistopathologyWorking recommendation

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.