Crohn's Desease
Accurately Diagnosing
An accurate professional diagnosis is the first step in treating Crohn’s. Proper diagnosis is particularly important with a condition like Crohn's, because its symptoms may mimic those of other conditions and its effects are chronic, progressing over time.
Diagnostic tests
To confirm his or her diagnosis — and to rule out other conditions that can cause similar symptoms, such as other inflammatory bowel diseases, colitis, celiac disease, or irritable bowel syndrome — your physician will probably perform a complete physical examination and order medical tests.
These diagnostic tests may include:
Blood tests: Although a complete blood count cannot provide a positive diagnosis of Crohn's, physicians usually order the test in suspected cases because it may reveal intestinal bleeding, an infection, or an inflammatory condition.
Radiologic examinations: These exams help your physician see inside your body to determine whether you have Crohn’s. Different types of tests include:
Barium enema: This test helps physicians visualize the colon and rectum.
Upper GI and small bowel follow-through: In this test, x-rays help examine the esophagus, stomach, duodenum, and small intestine after a patient drinks a barium-based liquid.
Enteroclysis: In this test, a tube is inserted into the nose and guided through the stomach to the duodenum, which is where the small intestine begins. A barium-based liquid is then infused through the tube, and x-rays are used to reveal abnormalities within the small intestine.
Computerized tomography (CT) scan: This extremely precise x-ray is used to detect abnormalities in the liver, kidneys, and intestines after a dye is ingested, administered intravenously, or inserted through the rectum.
Ultrasound: By using sound waves, this test examines organs of the pelvis and abdomen without exposure to radiation.
Magnetic resonance imaging (MRI): By using radio waves and superconducting magnets, this test can help detect fistulas and abscesses within a person’s body without exposure to radiation.
Stool Tests: These noninvasive tests examine stool samples to determine whether a patient has Crohn’s disease, ulcerative colitis, or a bacterial infection.
Urine Tests: Also called urinalysis, these tests are used to detect the presence of bacteria, red blood cells, and white blood cells in your urine. When bacteria and white blood cell levels are raised, it may indicate a urinary tract infection, which can be a complication of Crohn’s.
Endoscopic Examinations: These tests use a tool called an endoscope — a thin, flexible, lighted tube that is linked to a computer and video monitor. In an endoscopic exam, the endoscope is inserted into the rectum, mouth, or small abdominal incision to give gastroenterologists a detailed view of the intestinal tract.
Different endoscopic exams may include:
Sigmoidoscopy: This test is the most commonly performed endoscopic exam used to confirm a diagnosis of Crohn’s. By using either a flexible or rigid instrument, a physician can evaluate the rectum and lower end of the colon for signs of inflammation.
Colonoscopy: This test examines the full length of the colon, as well as the lower part of the small intestine.
Upper endoscopy: In this exam, an endoscope is placed into a patient’s mouth and guided through the stomach to the upper intestine.