Inflammatory Bowel Disease (cont.)

Exams and Tests

Your health care provider makes the diagnosis of inflammatory bowel disease based on your symptoms and various exams and tests.
 
Stool examination

• A stool examination is done to eliminate the possibility of bacterial, viral, or parasitic causes of diarrhea.

• A fecal occult blood test is used to examine stool for traces of blood that cannot be seen with the naked eye.

Complete blood count

• An increase in the white blood cell count suggests the presence of inflammation in the body. 
  
  
• If you have severe bleeding, the red blood cell count may decrease and hemoglobin level may fall (anemia).

Both the above tests are not diagnostic of IBD, as they may be abnormal in many other diseases.
 
Barium x-ray

• Upper gastrointestinal (GI) tract: This exam uses x-rays to find abnormalities in the upper GI tract (esophagus, stomach, duodenum, sometimes the small intestine). For this test, you are required to swallow barium (a chalky white substance). When barium is swallowed, it coats the inside of the intestinal tract, which can be documented on x-rays. If you have Crohn's disease, abnormalities will be seen on barium x-rays.
  
  
• Lower gastrointestinal (GI) tract: In this exam, barium is given in an enema that is retained in the colon while x-rays are taken. Abnormalities will be noted in the rectum and colon in persons with Crohn's disease and ulcerative colitis.

Sigmoidoscopy: In this procedure, your health care provider uses a sigmoidoscope (a narrow, flexible tube with a lens and a light source) to visualize the last one-third of the large intestine, which includes the rectum and the sigmoid colon. The sigmoidoscope is inserted through the anus and the intestinal wall is examined for ulcers, inflammation, and bleeding. During this procedure, your health care provider may take samples (biopsies) of the lining of the intestine.

Colonoscopy: A colonoscopy is an examination similar to a sigmoidoscopy, but with this procedure, the entire colon can be examined.

Upper endoscopy: If you have upper GI symptoms (nausea, vomiting), an endoscope (narrow, flexible tube with a light source) is used to examine the esophagus, stomach, and the duodenum. The endoscope is inserted through the mouth, and the stomach and duodenum are examined for ulceration. Ulceration occurs in the stomach and duodenum in 5-10% of persons with Crohn's disease.