Background: Inflammatory bowel disease (IBD) is increasingly reported in Africa, but diagnosis is frequently constrained by limited access to lower gastrointestinal (GI) endoscopy, histopathology, and specialist services. We compared socio-demographic characteristics and documentation of investigations/procedures among patients diagnosed with IBD versus other gastrointestinal diseases (GD) at Kenyatta National Hospital (KNH), Kenya. Methods: We conducted a retrospective case–control review of KNH medical records from January 2011 to December 2024. Cases had a clinician-documented diagnosis of Crohn’s disease and/or ulcerative colitis. Controls had other GD diagnoses. We summarized participant characteristics and documented investigations/procedures. Groups were compared using χ²/Fisher’s exact tests, and binary logistic regression estimated adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: Among 151 records, 45 (29.8%) were IBD and 106 (70.2%) were other GD. No socio-demographic variable (age group, sex, education, marital status, occupation) differed significantly between groups (p>0.05). Lower GI endoscopy (colonoscopy and/or sigmoidoscopy, recorded in charts as “endoscopy”) was documented more often among IBD than GD (40.0% vs 30.2%; p=0.046). Gastroscopy/EGD was more frequently documented among GD than IBD (18.9% vs 2.2%; p=0.007), consistent with the GD case-mix. CT and MRI were infrequently documented and typically lacked protocol detail, for instance enterography vs non-specific imaging. In adjusted models, documented lower GI endoscopy was associated with being in the IBD diagnosis group (aOR 2.73; 95% CI 1.14–6.54; p=0.024), while gastroscopy (aOR 0.06; 95% CI 0.006–0.64; p=0.020) and jejunostomy (aOR 0.17; 95% CI 0.04–0.81; p=0.026) were inversely associated. These associations likely reflect diagnostic suspicion and access/documentation rather than causality. Conclusion: Socio-demographics did not distinguish IBD from other