Diagnosis

Your doctor will likely diagnose inflammatory bowel disease only after ruling out other possible causes for your signs and symptoms. To help confirm a diagnosis of IBD, you may have one or more of the following tests and procedures:

Blood tests

  • Tests for anemia or infection. Your doctor may suggest blood tests to check for anemia — a condition in which there aren't enough red blood cells to carry adequate oxygen to your tissues — or to check for signs of infection from bacteria or viruses.
  • Fecal occult blood test. You may need to provide a stool sample so that your doctor can test for hidden blood in your stool.

Endoscopic procedures

  • Colonoscopy. This exam allows your doctor to view your entire colon using a thin, flexible, lighted tube with an attached camera. During the procedure, your doctor can also take small samples of tissue (biopsy) for laboratory analysis. Sometimes a tissue sample can help confirm a diagnosis.
  • Flexible sigmoidoscopy. Your doctor uses a slender, flexible, lighted tube to examine the rectum and sigmoid, the last portion of your colon. If your colon is severely inflamed, your doctor may perform this test instead of a full colonoscopy.
  • Upper endoscopy. In this procedure, your doctor uses a slender, flexible, lighted tube to examine the esophagus, stomach and first part of the small intestine (duodenum). While it is rare for these areas to be involved with Crohn's disease, this test may be recommended if you are having nausea and vomiting, difficulty eating or upper abdominal pain.
  • Capsule endoscopy. This test is sometimes used to help diagnose Crohn's disease involving your small intestine. You swallow a capsule that has a camera in it. The images are transmitted to a recorder you wear on your belt, after which the capsule exits your body painlessly in your stool. You may still need an endoscopy with a biopsy to confirm a diagnosis of Crohn's disease.
  • Balloon-assisted enteroscopy. For this test, a scope is used in conjunction with a device called an overtube. This enables the doctor to look further into the small bowel where standard endoscopes don't reach. This technique is useful when a capsule endoscopy shows abnormalities, but the diagnosis is still in question.

Imaging procedures

  • X-ray. If you have severe symptoms, your doctor may use a standard X-ray of your abdominal area to rule out serious complications, such as a perforated colon.
  • Computerized tomography (CT) scan. You may have a CT scan — a special X-ray technique that provides more detail than a standard X-ray does. This test looks at the entire bowel as well as at tissues outside the bowel. CT enterography is a special CT scan that provides better images of the small bowel. This test has replaced barium X-rays in many medical centers.
  • Magnetic resonance imaging (MRI). An MRI scanner uses a magnetic field and radio waves to create detailed images of organs and tissues. An MRI is particularly useful for evaluating a fistula around the anal area (pelvic MRI) or the small intestine (MR enterography). Unlike a CT, there is no radiation exposure with an MRI.
Aug. 09, 2017
References
  1. Goldman L, et al., eds. Inflammatory bowel disease. In: Goldman-Cecil Medicine. 25th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed May 10, 2017.
  2. What is inflammatory bowel disease (IBD)? Centers for Disease Control and Prevention. https://www.cdc.gov/ibd/what-is-IBD.htm. Accessed July 7, 2017.
  3. Overview of inflammatory bowel disease. The Merck Manual for Health Care Professionals. http://www.merckmanuals.com/professional/gastrointestinal-disorders/inflammatory-bowel-disease-ibd/overview-of-inflammatory-bowel-disease. Accessed July 7, 2017.
  4. IBD overview. American College of Gastroenterology. http://patients.gi.org/topics/inflammatory-bowel-disease/#tabs2. Accessed July 7, 2017.
  5. IBD 101: What is inflammatory bowel disease? American Gastroenterological Association. http://www.gastro.org/info_for_patients/ibd-101-what-is-inflammatory-bowel-disease. Accessed July 7, 2017.
  6. Peppercorn MA, et al. Clinical manifestations, diagnosis, and prognosis of ulcerative colitis in adults. https://www.uptodate.com/contents/search. Accessed July 7, 2017.
  7. What is colorectal cancer screening? Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/colorectal/basic_info/screening/. Accessed May 12, 2017.
  8. Feldman M, et al. Ulcerative colitis. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed June 20, 2017.
  9. Inflammatory bowel disease. U.S. Department of Health and Human Services. https://www.womenshealth.gov/a-z-topics/inflammatory-bowel-disease. Accessed July 7, 2017.
  10. The role of endoscopy in inflammatory bowel disease. Gastrointestinal Endoscopy. 2015;81:1101.
  11. Ulcerative colitis. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/ulcerative-colitis. Accessed June 20, 2017.
  12. Diet, nutrition, and inflammatory bowel disease. Crohn's & Colitis Foundation of America. http://www.crohnscolitisfoundation.org/. Accessed May 15, 2017.
  13. Inflammatory bowel disease. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed June 21, 2017.
  14. Complementary and alternative medicine (CAM). Crohn's & Colitis Foundation. http://www.crohnscolitisfoundation.org/resources/complementary-alternative.html. Accessed June 21, 2017.
  15. Yanai H, et al. Complementary therapies in inflammatory bowel diseases. Current Gastroenterology Reports. 2016;18:62.
  16. Brown A. Allscripts EPSi. Mayo Clinic, Rochester, Minn. July 17, 2017.
  17. Rajan E (expert opinion). Mayo Clinic, Rochester, Minn. July 14, 2017.