Once considered rare in pediatric practice, chronic inflammatory bowel disease is now recognized with increasing frequency in children. Ulceractive colitis and Crohn disease constitute the two major entities, and it is still not clear whether these are two separate entities or different portions of the spectrum of one disease. Abdominal pain, diarrhea, rectal bleeding, weight loss, and anemia are prominent findings in both ulcerative colitis and Crohn disease; however, extraintestinal manifestations may dominate the clinical findings, masquerading as juvenile rheumatoid arthritis, idiopathic growth failure, or even anorexia nervosa. Often, it is not until intestinal manifestations are recognized that a correct diagnosis is made.1