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Diagnosing inflammatory bowel disease


Diagnosing inflammatory bowel disease

Inflammatory bowel disease is a term for two chronic, autoimmune diseases characterized by inflammation in the digestive tract: ulcerative colitis, which affects the large intestine and rectum, and Crohn’s disease, which can affect any part of the digestive tract.

The range of symptoms, from bloody stool to abdominal pain, can make IBD a challenge to diagnose, along with the fact that severity can range from mild to severe depending on the person.

“There isn’t a single test that can pinpoint Crohn’s disease or ulcerative colitis,” says Dr. Christopher Bach, who specializes in digestive diseases at Tidelands Health Gastroenterology at The Market Common and Murrells Inlet. “For that reason, it’s important patients work closely with their physician to weed out any other potential causes of digestive distress to narrow the diagnosis.”

If you have a history of abdominal pain, loose stools, blood in your stools or unexplained weight loss, speak with your physician or another qualified care provider. Your care provider may order one or more of the following tests to determine if inflammatory bowel disease is the cause:

Blood tests

This is typically the first stop on a potential IBD diagnosis. Your physician will likely order blood tests for c-reactive protein and erythrocyte sedimentation rate to determine if there’s inflammation within the body. Your physician may also order a complete blood count to check for anemia and bleeding within the GI tract.

Stool tests

Providing a stool sample lets your physician check for blood that may be hidden in your stool, along with parasites or other organisms that may be causing distress. Additionally, your physician may want to test fecal biomarkers to include calprotectin and lactoferrin, both of which are proteins found in stool that can indicate gastrointestinal inflammation.


A CT or MRI scan is a non-invasive way your physician can examine your digestive system for potential causes of intestinal problems. MRI can examine the small intestine, which lies beyond the reach of endoscopes. In the case of CT scans, imaging specialists may have you drink a chalky liquid containing barium, an element that will coat the inside of your digestive system and help the soft tissues show up better on the images. A special type of X-ray known as a fluoroscope will let doctors see the barium move through your gastrointestinal (GI) system in real time in a procedure known as an upper GI series.


The most invasive, but incredibly important, form of testing uses a tool known as an endoscope, which is a small camera and light mounted on the end of a flexible tube, to examine your digestive system from the inside. This procedure helps your physician see if inflammation is present, where it is located, assess its severity and obtain tissue samples to confirm your diagnosis.

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“A combination of tests helps physicians rule out other potential issues, such as diverticulitis, that might have similar symptoms,” Bach says. “If you’re experiencing potential IBD symptoms, it’s a good idea to keep a record of when and under what conditions they occur. That’s important information that will help your doctor determine the most effective course of action.”

While there is no cure for autoimmune diseases, there are ways to mitigate their impact through certain therapies, procedures or lifestyle changes, Bach says. Anti-inflammatory medications are often the first step toward treating mild or moderate disease. For more severe cases, immune-suppressing intravenous infusions can block the proteins your body produces that cause inflammation.

In other cases where other treatments fail to provide relief, physicians may turn to surgery to remove the damaged portions of your digestive tract.

“Your treatment depends on how severe your symptoms are and can change throughout the course of your life with the disease,” Bach says. “If you struggle with frequent abdominal pain, diarrhea, blood or mucus in your stools or even chronic constipation, reach out to your care provider and get things checked out.”

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