Crohn’s Disease Diagnosis and Testing

Crohn’s disease has a wide range of symptoms that vary from person to person. We are by your side as you navigate the diagnostic process, letting you know what to expect each step of the way.

There is no single test to confirm a Crohn’s diagnosis, and Crohn’s disease symptoms are often similar to other conditions, including bacterial infection. Your healthcare providers should evaluate your current medical history and use information from diagnostic testing to exclude other potential causes of your symptoms. This process can take some time.

If you feel you or your loved one are experiencing symptoms that could be Crohn's disease, be sure to see your doctor as soon as possible.

Initial Testing and Evaluation

The first step to diagnosis and treatment is a standard physical exam of your body. Your doctor will speak to you and ask questions about your overall health, diet and nutrition, family history, and your daily routine.

What to Expect

• Your doctor may order diagnostic testing to look for signs of Crohn’s disease and rule out other possible medical conditions.

• Your first tests will likely include laboratory tests of your blood and stool.

• Further testing could include X-rays of the upper and lower GI tract. Your doctor may recommend a test that uses a contrast chemical that helps your doctors see a more clear and detailed picture of your GI tract. The type of contrast used varies by test.

• Consider bringing a trusted family member or close friend to your appointments. This may help ease your stress and help you later remember information from your doctor.

Communication Tips

• Write down your symptoms and bring it to your appointments, so you don’t have to worry about forgetting anything important.

• Ask your healthcare team which test is best for you, and contact your insurance to understand coverage of costs.

Endoscopy and Imaging

Your doctor may recommend additional testing to look inside your GI tract and intestine. While these tests are more invasive and may sound frightening,  they are often done in an outpatient setting and your health care providers will be careful to minimize any discomfort.

Endoscopy

Your doctor may recommend an endoscopy to get a detailed look at the inside of your  colon using a small camera mounted to the end of a lighted tube.

Endoscopies used in Crohn’s disease testing include:

• A colonoscopy allows doctors to examine the colon, the lowest part of your large intestine, by inserting a flexible, lighted tube through the opening to your anus.

• An upper endoscopy lets doctors see the gastrointestinal tract from the top down, using a flexible, lighted tube that’s inserted through your mouth, down the esophagus, into your stomach and as far down as the duodenum, which is the first section of your small intestine.

Colonoscopies require bowel preparation. Talk to your healthcare team about ways to prepare, and tips for making this preparation easier.

Biopsy

Your doctor may want to get a biopsy of your colon or another area of your GI tract while performing a colonoscopy or endoscopy. During the biopsy, a small piece of tissue is removed from the inside of the intestine for further testing and analysis.

• Your biopsied tissue will be analyzed in a pathology laboratory and screened for disease. Biopsies are also used for colorectal cancer screening.

• While a biopsy sounds scary, medical advances have made this procedure virtually pain-free.

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Chromoendoscopy

Your doctor may want use this technique during a colonoscopy to look for polyps or precancerous changes.

• During a chromoendoscopy, a blue liquid dye is sprayed into the colon to highlight and detect slight changes in the lining of your intestine.

• Polyps can then be removed and/or biopsied.

• It is common to have blue bowel movements following this procedure.

Small Intestine Imaging

These tests are used to examine portions of your intestine that can’t be easily seen by colonoscopy or endoscopy. They work by using an oral contrast that you drink and that can be seen on a fluoroscopic X-ray, computed tomography (CT) scan or a magnetic resonance imaging scan (MRI).

• You may also hear these tests referred to as enterography or enteroclysis.

• Your doctor may a have you swallow a small, pill-sized camera, which will take pictures of the small intestine and bowel as it travels through your GI tract. The camera is later expelled during a bowel movement.

• A balloon endoscopy may be needed to view hard-to-reach areas of the intestine.

Communication Tips

• Ask your healthcare providers what to expect during the procedure and if there are any risks to consider.

• Most of the testing for Crohn’s disease is done in an outpatient setting. Consider have a friend or family member drive you to keep you company and put your mind at ease.

If you are concerned about the costs of managing your care or your health insurance coverage, we can help you find financial resources. We can also help you find a doctor in your area. Learn more about common terms related to Crohn's disease and ulcerative colitis by exploring the Crohn's & Colitis Glossary.

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