Diseases of the gastrointestinal tract are common. Accurate diagnosis of these diseases is an important part of our practice. The differential diagnosis in the workup of abdominal pain and diarrhea is broad, and the role of the surgical pathologist is to carefully evaluate biopsies and resections for morphologic changes indicative of disease. Accurate early diagnosis of chronic inflammatory bowel disease is crucial, as is the ongoing surveillance for disease activity and precancerous dysplastic changes. Colon malignancies are evaluated for Lynch syndrome as well as additional molecular analysis depending on clinical indications. Difficult cases are reviewed during our daily intra-departmental case conference. Our fellowship-trained gastrointestinal pathologist is always available to consult on the most challenging cases of the day.