Ischaemic colitis (IC) is themost frequent formof gastrointestinal ischaemia. Discrepancy between non- specific symptoms and objective findings is a hallmark of IC. Thus delay of diagnosis is common due to its often subtle and unpredictable presentation. In particular, the clinical symptoms and signs of IC can overlap with those of inflammatory bowel disease. We present a case of a young man with known factor- V- Leiden mutation in whom IC developed during effective therapy with oral anticoagulants, presenting with symptoms and endoscopic findings suggestive of inflammatory bowel disease. Ischaemic colitis (IC) is themost frequent form of gastrointestinal ischaemia. Objectives of the disease are non-specific symptoms and objective findings are a hallmark of IC. of IC can overlap with those of inflammatory bowel disease. We present a case of a young man with known factor- V- Leiden mutation in whom IC published during effective therapy with oral anticoagulants, presenting with symptoms and endoscopic findings suggestive of inflammatory bowel disease.