Crohn’s Disease Diagnosis
Tools for diagnosing Crohn’s
- Plain X-Rays are pictures of the inner organs. They will be conducted first so that any injuries in the abdomen and possible perforations in the intestines and colon can be identified.
- Contrast X-Rays also known as Barium X-Rays will only be conducted if the possibility of a perforated intestine and/or obstruction is ruled out. These x-rays track movement of the liquid through the intestine.
- Tumors of colon, polyps, diverticulitis, and anatomical abnormalities can be found using barium x-rays.
X-Rays not only help doctors look at broken bones but help them take a look at many other injuries including those in the abdominal area. They are a quick picture of the inside of the body. There are two types of X-Rays and both are used when dealing with IBD.
Plain X-Rays are able to show narrowing and blockages or obstructions in the intestines. This can occur as a result of inflammation and scarring within the intestine. Getting a plain x-ray helps rule out the possibility of injuries affecting the area around the abdomen. One condition that doctors would like to immediately rule out is that of a perforated colon which is why plain x-rays go first.
Barium, liquid or contrast x-rays are used to track the movement of barium; the chalky, thick, liquid you sip on as a prep while in the waiting room. Usually these are for looking at a contrast image of the small intestine and to observe that the barium travels uniformly. When getting a contrast x-ray of the large intestine the procedure will be a little different. Doctors will instruct you to follow a bowel cleansing routine the day before. The barium will be inserted (via enema) into your rectum.
This may be the only procedure that your doctor will need to provide you with a diagnosis of Crohn’s, or it may not. Barium X-Rays are definitely not safe for everybody. If you have ever had a severe obstruction, or may have a perforated colon or intestine ALERT your doctor so that another technique can be used. After all, there are several ways to safely attain a correct Crohn’s Diagnosis.
Crohn’s Diagnosis with Endoscopy
3 parts of endoscopy
Endoscopy is a nonsurgical procedure used to examine a person’s digestive tract. A gastroenterologist will use a flexible tube with a camera and light attached to it. This instrument is called an endoscope, it produces the imaging a team of doctors will examine.
Upper Endoscopy is used to explore the first part of the intestine. The scope is inserted through the mouth and the esophagus, stomach, and first part of the small intestine are examined. Likewise to the other methods using an endoscope, before the procedure the doctor will sedate you quickly.
Ideal drugs for endoscopic sedation have a rapid onset and short duration of action, maintain hemodynamic stability, and do not often cause major side effects. Commonly used agents include opiates, such as meperidine or fentanyl, benzodiazepines, such as midazolam or diazepam, or a hypnotic, such as propofol.
Endoscopy can be broken down into 3 factors. This applies for all methods. You will be under general anesthesia, the doctor will insert a fiberoptic scope, and will have the retrograde visualization or imaging. The imaging will be examined looking for lesions, ulcers, or any abnormality.
- general anasthesia
- fiberoptic scope
- retrograde visualization of intestine
One procedure that will help your doctor make the proper determination whether you’re suffering from Crohn’s This procedure involves the use of a thin and flexible lighted tube, with a camera attached to it, allowing your doctor to see any signs of inflammation at the same time, sample tissues may be taken to confirm a diagnosis of ulcerative colitis. Results from an upper endoscopy may be inconclusive, and your doctor will suggest an endoscopy and colonoscopy together to have more information before drawing a conclusion.
This is a procedure people will avoid because of feelings of embarrassment or fear. Do not fret. Doctors perform many of these procedures and it helps them determine many health issues. In a colonoscopy like the name suggests the endoscope is inserted through the rectum and projects images of the colon. With the use of the thin and flexible lighted tube, with a camera attached to it, your doctor can more freely spot signs of inflammation at the same time, sample tissues will usually be taken for examination.
Like colonoscopy, this test will still utilize the thin and flexible lighted tube that will be examining the last part of your colon. However, in the case of high inflammation in the colon, your doctor may just have you undergo sigmoidoscopy instead of a colonoscopy.
ERCP (Endoscopic retrograde cholangiopancreatography)
This involves examination of the bile ducts in the liver and the pancreatic duct. This test finds finds a fairly rare liver disease called Primary Sclerosing Cholangitis (PSC). Usually, a Crohn’s or Ulcerative Colitis Testing and Diagnosis procedure helps to identify this, however it is very uncommon.
This may not be as “regular” as a urine test, but this may be the most foolproof procedure that will help your doctor make the proper determination whether you’re suffering from ulcerative colitis. This procedure involves the use of a thin and flexible lighted tube, with a camera attached to it, allowing your doctor to see any signs of inflammation at the same time, sample tissues
CT Scans are efficient prior to a diagnosis as well as after.
A CT Scan spots other issues in the body, and can be compared to previous or newer scans so that differences in appearance in the intestinal walls can be clearly seen.
Imaging is most commonly performed to examine the brain and spine. However, intestinal imaging offers advantages to both the patient and doctor. The scan focuses on the abdomen and the pelvic area. A CT scan is an easy and noninvasive procedure. In terms of accuracy, CT scan is agreed as a reliable tool in locating inflammation in the bowels.
Essentially, your doctor requests lab work to evaluate how well organs are working and sometimes diagnose diseases. Although, Crohn’s Disease cannot be diagnosed through blood work, it is a helpful tool in Crohn’ diangnosis, testing, and treatment.
Routine blood work helps identify conditions that may sometimes be mistaken as IBS Irritable Bowel Syndrome, or IBD Inflammatory Bowel Diseases . This is a common problem with symptoms such as rectal bleeding, fatigue, abdominal pain, and brain fog which are symptoms for many other conditions.
Types of blood tests for IBD
- Full blood count (FBC)
- Ferritin and transferrin tests
- Inflammatory marker tests
- Urea and electrolytes (U&E)
- Thiopurine s-methyltransferase test (TPMT)
- Liver function tests (LFT) also known as liver enzyme test
- Tests for vitamins and minerals (Vitamin B12, Calcium, Phosphate, etc.)
IBD Stool Sample
Your doctor may also require you to provide a stool exam before reaching a conclusion in the case of Crohn’s Disease. This helps the doctor ensure your symptoms are in fact IBD related and not caused by a virus, bacteria or a parasite. Ileitis or Crohn’s is indicated by the white blood cell count in the stool.
The process is pretty simple. You get the items (container and bag) for the stool sample from your doctor usually. You collect the sample at home and take it to the lab who then analyzes it and send the results to your doctor.