Ulcerative Colitis Diagnosis and Testing

The path to receiving a chronic disease diagnosis can be overwhelming and even frightening at times. The best thing you can do during this time is be educated and prepared. We can help you understand the process of diagnosing ulcerative colitis and learn about common procedures your healthcare team may recommend.

An ulcerative colitis diagnosis is based on several factors, including your medical history, a physical exam, and a series of medical tests. The tests your doctor recommends will help your healthcare team determine if you have ulcerative colitis and which type of ulcerative colitis you have.  

Initial Testing and Evaluation

Your doctor will conduct a physical exam and ask you questions about your general health, diet, family history, home environment, and your daily activities.

Your doctor may then recommend a series of diagnostic tests. In addition to diagnosing ulcerative colitis, these tests are also performed to rule out infection.

What to Expect

  • Your doctor will likely recommend laboratory tests of your blood and fecal matter.

  • Your stool specimen will be analyzed to eliminate the possibility that your symptoms are caused by bacteria, a virus, or a parasite.

  • Blood tests can look for signs of infection as well as anemia, which could indicate bleeding in your colon or rectum.

  • Further testing could include X-rays. 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 Tip

Endoscopy and Biopsy

Your doctor may recommend additional testing to look for signs of disease inside your colon and rectum. These tests are typically done in an outpatient setting and your health care providers will be careful to minimize any discomfort.


An endoscopy allows doctors to examine the inside of your colon and rectum with a lighted tube inserted through your anus. There are two types of endoscopies used during ulcerative colitis testing:

  • A sigmoidoscopy allows your doctor to examine the extent of the inflammation in your lower colon and rectum.

  • A total colonoscopy is a similar to the sigmoidoscopy, but this procedure allows your doctor to examine your entire colon.

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


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.  


Your doctor may want to get a biopsy of your colon while performing an 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.

  • There may be small amounts of blood in your stool after a biopsy.

  • While a biopsy sounds scary, medical advances have made this procedure virtually painless.

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 ulcerative colitis 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.


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