BACKGROUND: Proper management of patients with inflammatory bowel disease depends upon a definitive diagnosis, which is best arrived at in the clinicopathological conference (CPC). The aim of the study was to assess the impact of a combined clinical and pathological form called Performa on the definitive diagnostic rate and to see if this improvement was comparable with results achieved with CPCs. METHODS: Between June 2003 and December 2003, 77 consecutive patients were included in the study. Histological data recorded on the performa were reviewed by one consultant pathologist after the initial reporting to see if there was any change in diagnosis. All cases were also discussed in the CPC as per guidelines. RESULTS: The use of the combined form significantly increased the definitive diagnostic rate by decreasing the unclassifiable group by 23.6%, and was comparable to that achieved by CPC. CONCLUSIONS: In the absence of a CPC, the proposed form is an efficient substitute.