Your doctor will likely diagnose Crohn's disease only
after ruling out other possible causes for your signs and symptoms, including
irritable bowel syndrome (IBS), diverticulitis and colon cancer. To help
confirm a diagnosis of Crohn's disease, you may have one or more of the
following tests and procedures:
·
Blood tests. 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. Two tests that look for the presence of certain
antibodies can sometimes help diagnose which type of inflammatory bowel disease
you have, but not everyone with Crohn's disease has these antibodies. While
your doctor may order these tests, a positive finding doesn't mean you have
Crohn's disease and a negative finding doesn't mean that you're free of the
disease. Because these tests aren't yet definitive, the American College
of Gastroenterology doesn't currently recommend antibody or genetic testing for
Crohn's disease.
·
Fecal occult blood test. You
may need to provide a stool sample so that your doctor can test for blood in
your stool.
·
Colonoscopy. This
test 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, which may
help confirm a diagnosis. Some people have clusters of inflammatory cells
called granulomas, which help confirm the diagnosis of Crohn's disease because
granulomas don't occur with ulcerative colitis. Risks of colonoscopy include
perforation of the colon wall and bleeding.
·
Flexible sigmoidoscopy. In
this procedure, your doctor uses a slender, flexible, lighted tube to examine
the sigmoid, the last section of your colon.
·
Computerized tomography (CT). 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 that can't be seen with other tests. Your doctor may order
this scan to better understand the location and extent of your disease or to
check for complications such as partial blockages, abscesses or fistulas.
Although not invasive, a CT scan exposes you to more radiation than a
conventional X-ray does. 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. An
MRI scanner uses a magnetic field and radio waves to create detailed images of
organs and tissues. Most MRI machines are large, tube-shaped magnets. During
the test, you lie on a movable table inside the MRI machine. This test is very
helpful in diagnosing and managing Crohn's disease. It's biggest advantage is
that there is no radiation exposure. It's particularly useful for evaluating a
fistula around the anal area (pelvic MRI) or the small intestine (MRI
enterography).
·
Capsule endoscopy. If
you have signs and symptoms that suggest Crohn's disease but other diagnostic
tests are negative, your doctor may perform capsule endoscopy. For this test
you swallow a capsule that has a camera in it. The camera takes pictures, which
are transmitted to a computer that you wear on your belt. The images are then
downloaded, displayed on a monitor and checked for signs of Crohn's disease.
Once it's made the trip through your digestive system, the camera exits your
body painlessly in your stool. Capsule endoscopy is generally very safe, but if
you have a partial blockage in the bowel, there's a slight chance the capsule
may become lodged in your intestine. In addition, the images provided by
capsule endoscopy may not be detailed enough. Endoscopy with biopsy is often
still needed to confirm the diagnosis of Crohn's disease and to exclude other
causes of your symptoms.
·
Double balloon endoscopy. For
this test, a longer scope is used to look further into the small bowel where
standard endoscopes don't reach. This technique is useful when capsule
endoscopy shows abnormalities, but the diagnosis is still in question. It allows
for biopsy of the abnormal area. It's usually performed in specialized
endoscopy centers.
·
Small bowel imaging. This
test looks at the part of the small bowel that can't be seen by colonoscopy.
After you drink a solution containing barium, X-ray, CT or MRI images are taken
of your small intestine. The test can help locate areas of narrowing or
inflammation in the small bowel that are seen in Crohn's disease. The test can
also help your doctor determine which type of inflammatory bowel disease you
have.
·
Barium enema. This
diagnostic test allows your doctor to evaluate your large intestine with an
X-ray. Before the test, you receive an enema with a contrast solution
containing barium. The barium dye coats the lining of the bowel, creating a
silhouette of your rectum, colon and a portion of your small intestine that's
visible on an X-ray. This test is rarely done anymore because of the
availability of colonoscopy and CT scanning.
Cancer surveillance
Screening for colon cancer may need to be done more frequently because people who have Crohn's disease that affects the colon have an increased risk of colon cancer. General colon cancer screening guidelines call for a colonoscopy every 10 years beginning at age 50. Ask your doctor if you need to have this test done sooner and more frequently.
Screening for colon cancer may need to be done more frequently because people who have Crohn's disease that affects the colon have an increased risk of colon cancer. General colon cancer screening guidelines call for a colonoscopy every 10 years beginning at age 50. Ask your doctor if you need to have this test done sooner and more frequently.
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