The Road to an IBD Diagnosis

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IBD, specifically Crohn's disease and ulcerative colitis, is an autoimmune disease that can be difficult to diagnose. Here is how a typical case is diagnosed.

The symptoms

Both forms of IBD will carry similar symptoms. These symptoms can include diarrhea, rectal bleeding, upset stomach, fever, loss of appetite, weight loss, anal ulcers and fistulas.

Track your symptoms

IBD symptoms will often overlap with other diseases. If you suspect you have IBD, it is important to track your symptoms as well as you can so your doctor has a clear picture of your health and your symptoms.

Go to the doctor

Now that you've tracked your symptoms and food sensitivities, it's time to take your case to the doctor. Present your case as clearly and accurately as you can and explain your concerns. Understand that you might be wrong about your "self-diagnosis" and listen very carefully to the doctor. If you leave uneasy, don't be afraid to seek out a second opinion.

Family history and physical

If your doctor shares your suspicions of IBD, a battery of tests will be done to definitively diagnose your condition. First, the doctor will take a complete and thorough family history (IBD can run in families) and physical to rule out other conditions.

Blood test and stool sample

Blood tests and stool samples are usually the first set of tests a doctor will order to determine if a case of IBD exists. A blood test may show an increased white blood cell count that could suggest inflammation, while a stool sample will look for blood or traces of infectious organisms. Both are helpful in diagnosing IBD.

Standard endoscopic procedures

If a family history and blood tests point to a possible IBD case, the physician will most likely perform some kind of endoscopic procedure to check for abnormalities inside the colon. He or she can also take tissue samples from the colon. These procedures are usually used to distinguish between ulcerative colitis and Crohn's disease.


An intestinal wall ultrasound has proved useful for identifying the extent and severity of Crohn's disease. This technology is relatively new but may be helpful for some patients.

Upper and lower gastrointestinal barium x-rays

The upper and lower gastrointestinal barium x-rays are useful if IBD, specifically Crohn's disease, is detected in the small intestine. The patient will swallow a barium solution, which passes into the small intestine and illuminates on an x-ray. The x-ray will reveal any inflammation, ulcers or other abnormalities that may suggest IBD.

Rule out other diseases

Many gastrointestinal conditions have the same basic symptoms as IBD. The battery of tests done to diagnose IBD are also done to rule out other less serious conditions, such as irritable bowel syndrome or more serious conditions, such as colon cancer. This is why it is especially important to communicate your symptoms as thoroughly and accurately as you can during the testing process.

Your diagnosis

Once you've been diagnosed, it is very important that you receive thorough instructions for follow-up care. Leave no question unanswered and no topic unexplored. If you doubt your diagnosis, ask for a second opinion and don't be afraid to see a specialist. If not, learn how to take the best care of yourself as possible and start living your life.