Medical history
In most cases, getting a diagnosis of inflammatory bowel disease (IBD) starts with your primary healthcare provider. They will first ask you about your symptoms and medical history. This information will help them decide if they need to do more tests. If you do not have a primary healthcare provider, visit Find A Doctor.
To give your healthcare provider as much information as possible, consider keeping track of some of your symptoms. This includes:
- the number of bowel movements you typically have each day
- how often you have diarrhea or watery stool
- how often you see blood in your stool
- how often you have belly pain or cramping and how serious the pain or cramping is
- how often you feel fatigued
You should also tell your healthcare provider if you have:
- family members with IBD
- a history of smoking cigarettes or if you currently smoke cigarettes
- had a Clostridioides difficile (C. diff) infection (this was previously called Clostridium difficile)
- a history of ulcers in your gastrointestinal (GI) tract
Tests and imaging
Your healthcare provider will consider your symptoms and history and may order tests, including blood tests, stool tests, and imaging tests to make a diagnosis.
- Blood tests provide information on inflammation and nutrient levels in your body. Your healthcare provider will use different parts of your blood test to rule out other health conditions and potentially make a diagnosis of IBD.
- Stool tests provide information on inflammation and infections. Your healthcare provider will usually check for a Clostridioides difficile (C. diff) infection, check for other bacterial infections (enteric cultures), and assess the levels of calprotectin in your stool.
- C. diff is a bacterium that can cause symptoms similar to those of IBD. It can also cause the symptoms of IBD to become worse.
- Calprotectin is a protein released by your white blood cells when they are fighting inflammation. Calprotectin in your stool can be a sign that your intestines are inflamed.
- Imaging tests like X-rays, ultrasounds, MRI scans, and CT scans can also help diagnose IBD.
Depending on the results of these tests, your healthcare provider may send you to see a specialist called a gastroenterologist so they can perform a scope and collect more information.
The tests used to monitor IBD are very similar to the tests used to diagnose IBD. After your diagnosis, your gastroenterologist will order blood tests and stool tests to monitor the levels of inflammation in your body and in your gastrointestinal GI tract. You may get more blood tests and stool tests when you start a new medicine, when you feel you are experiencing a flare, and before appointments.
Scope
Scopes are procedures done by gastroenterologists to see parts of the GI tract. They are used to confirm cases of IBD.
The 2 most common types of scopes used in IBD are upper endoscopies and colonoscopies.
- An upper endoscopy may also be called an EGD, an esophagoscopy, a gastroscopy, or an ileoscopy. During an upper endoscopy, the doctor will insert a flexible tube with a camera and light into your mouth. The doctor will move the camera through your throat and stomach and into your small intestine. They will move the camera around your small intestine and look for inflammation. They may take pictures or videos to review later. In some cases, the doctor may take samples of your GI tract tissue to send for testing.
- During a colonoscopy, the doctor will insert a flexible tube with a camera and light into your rectum. The doctor will move the camera through your large intestine and into the end of your small intestine and look for inflammation. They may take pictures or videos to review later. In some cases, the doctor may take samples of your GI tract tissue to send for testing.
In most cases, you will be sedated before your scope. Sedation will help you relax during the procedure and will reduce the pain and discomfort that you would normally feel. In some rare cases, patients are put under anesthesia for scoping procedures. Your healthcare provider can give you more information on the difference between sedation and anesthesia.
The procedures used to monitor IBD are very similar to the procedures used to diagnose IBD.
Your healthcare provider will use scopes to monitor the levels of inflammation in your GI tract after your diagnosis. You may get a scope done to confirm you have entered remission after a flare, to assess a complication, and to monitor your GI tract for signs of cancer.
