Crohn's Disease

Crohn's Disease Diagnosis

Due to its complex etiology (origins/set of causes) and placement in the IBD family of diseases, Crohn’s disease is often diagnosed indirectly by process of elimination. Your provider will first rule out all other possible causes for your symptoms. In other words, there is no “silver bullet” test that can be used to diagnose Crohn’s disease as opposed to, for example, ulcerative colitis. The tests and procedures that you will likely undergo before being diagnosed with Crohn’s disease include^[11]:

• Blood tests: Blood tests can be used to detect GI tract infections, as well as anemia (low blood cell count), one potential symptom of Crohn’s disease.
• Fecal occult blood test: This type of stool exam tests for “occult” (unexpected) blood in your stool.
• Colonoscopy: Because Crohn’s disease manifests in most patients with chronic (persistent), patchy inflammation in the ileum of the small intestine and/or colon, a colonoscopy will usually provide ample visual evidence for a diagnosis. This exam involves a provider using a thin, flexible camera on a tube to visually examine the colon. If warranted, a small tissue sample (biopsy) may be taken during a colonoscopy for further examination. If granulomas are present, this may support a diagnosis of Crohn’s disease.
• Capsule endoscopy: Similar to an endoscopy (but much less invasive), a capsule endoscopy involves swallowing a small, capsule-like camera. As the camera passes through your GI tract, it automatically takes pictures of the small intestine and colon, which are transmitted to a monitor display. Eventually, the capsule camera exits through your stool.
• Balloon-assisted enteroscopy: As its name suggests, this procedure involves using a camera scope alongside a balloon-like inflatable device (called an overtube), which allows a provider to look deeper into the small bowel. This is often performed if abnormalities are observed during a regular endoscopic procedure.
• Computerized tomography (CT) scan: CT scans are a common type of imaging test that provide a high level of detail of the body’s structures. A CT enterography of the small bowel and the colon is frequently used in diagnosing Crohn’s disease.
• Magnetic resonance imaging (MRI): MRIs rely on magnetic field and radio wave scanning to provide an unrivaled level of detail for visualizing organs and soft tissues. In the case of Crohn’s disease, MRIs are very useful for identifying fistulas in the pelvis and small intestine.

If you believe that you or a loved one may have Crohn’s disease or another form of IBD, it’s important to see a specialist, such as a gastroenterologist. Schedule a visit to see your provider, tell them why you suspect you might have Crohn’s disease, and ask for a checkup and a referral during your next visit.