Doctors may use blood, stool, and imaging tests to help diagnose IBD. However, endoscopy with biopsy is often essential to confirming a diagnosis and distinguishing between the two types.
Inflammatory bowel disease (IBD) is an umbrella term healthcare professionals use to describe disorders that cause chronic inflammation of the gastrointestinal (GI) tract.
The two types of IBD are:
- Ulcerative colitis (UC): affects the large intestine and rectum
- Crohn’s disease: can affect any part of the GI tract
The symptoms of IBD mimic other common conditions, so diagnosis can sometimes be a challenge.
Several tests and exams are available to help doctors identify IBD and distinguish between the two types. An accurate diagnosis is the first step to successful treatment and management of your symptoms.
A complete blood count can reveal your red and white blood cell levels. If you have fewer red blood cells than usual, you could have anemia. This can indicate bleeding in the colon or rectum. A high white blood cell count means there could be inflammation or an infection somewhere in your body.
Examining specific blood biomarkers, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), can also help doctors determine whether inflammation is present in your body.
Blood tests can often help doctors distinguish Crohn’s from UC. The presence of specific antibodies or biomarkers in a blood sample may indicate either condition.
Prognostic testing for IBD
Scientists are currently studying whether certain markers found in a person’s blood, tissue, or other bodily fluids could help predict whether they will experience mild or severe symptoms of IBD.
But while these “prognostic” tests are currently available, they’re still in the early stages of development and aren’t widely adopted.
You’ll provide a sample of your poop in a small container. Analysts at a lab examine the sample for causes of digestive diseases. Analyzing certain stool proteins, such as calprotectin and lactoferrin, can alert doctors if you have GI inflammation.
A stool sample can help doctors look for indicators of IBD and rule out other conditions that could be causing your symptoms, such as an infection.
Endoscopy procedures are
These tests typically involve examining the inside of the GI tract with an endoscope, a thin tube with a light and camera attached.
The doctor will also remove tissue samples (called a biopsy) to test for inflammation.
You’ll usually undergo these procedures in a hospital or outpatient center. Your care team will give you instructions on how to prepare for the procedure, which will require a few days of prep work, such as clearing your bowels.
A healthcare professional might order one or more of the following types of endoscopy:
- Colonoscopy: During a colonoscopy, a doctor uses an endoscope to view the entire colon and rectum.
- Upper GI endoscopy: In an upper GI endoscopy, a doctor gently directs an endoscope down your esophagus and into your stomach and duodenum (the first part of your small intestine) to look inside your upper digestive tract.
- Enteroscopy: An enteroscopy examines your small intestine.
- Flexible sigmoidoscopy: Doctors use sigmoidoscopy to view the rectum and the lower part of the colon if your colon is very inflamed.
Crohn’s may affect any part of the GI tract. However, as UC affects only the colon and rectum, it will only appear on a colonoscopy or sigmoidoscopy.
Doctors may also recommend radiographic imaging tests to get a better look at what’s going on inside your body.
Common imaging tests for IBD include:
- CT scan: CT scans use X-rays and computer technology to generate pictures of your GI tract. They may help doctors understand the extent of damage in your GI tract or rule out other conditions.
- CT enterography (CTE): CTE provides a more detailed scan than a regular CT. Before the scan, you drink a solution that makes it easier to see certain structures in your body.
- Magnetic resonance enterography (MRE): MRE is a noninvasive test that allows doctors to view detailed images of your small intestine. This is particularly helpful for checking for inflammation and signs of Crohn’s disease, like creeping fat.
- Upper GI series: Also known as a barium swallow, this test involves drinking a chalky liquid before undergoing an X-ray scan of your upper GI tract.
- Lower GI series: Rather than swallowing the barium, you receive a barium enema before X-ray observation of the colon and rectum.
Once a healthcare professional provides you with an IBD diagnosis, work with them to get a referral for a gastroenterologist who specializes in treating these diseases.
There’s no cure for IBD, but some therapies, procedures, and lifestyle changes can help you feel better and prevent complications. A gastroenterologist will likely start you on treatments and recommend lifestyle and dietary changes to help ease your symptoms.
Your treatment will depend on the severity of your condition and other factors. Most people with IBD can live full, active lives once they know how to avoid symptoms and complications.
IBD is a complex disease that’s sometimes difficult to diagnose. If you develop any symptoms of IBD, it’s best to see your doctor to learn more about what could be causing your discomfort.
Several tests — including lab work, endoscopies, and imaging exams — can help your doctor determine if you have IBD and what type. You and your doctor can work together to determine the optimal treatment plan for your condition.