The incidence of inflammatory chronic disease (ICD) in childhood has increased in the last
decades and this seems to be only partially due to increased diagnostic capability. The article
describes the diagnostic guide-lines recently developed by the Italian Society of Pediatric
Gastroenterology. The suggested approach includes for most cases where a ICD can be
suspected a first diagnostic step based on basic laboratory examinations (CRP, ESR and
blood count) and on ultrasound. The usefulness and indications of colonscopy and other investigations
are discussed. Clinical scores (Truelove index for UC and a Pediatric Crohn’s
Disease Index for CD) are recommended to assess the severity of disease.