Diagnosing Crohn's Disease
Diagnosing Crohn's Disease: Colonoscopy or Sigmoidoscopy
Colonoscopy and sigmoidoscopy allow the doctor to directly view the large intestine, which is the lower part of the digestive tract. These techniques can often provide the most accurate information about the intestines. They may be better at detecting small ulcers or inflammation than other techniques. They can be used to assess the severity of any inflammation. Colonoscopy is the most important tool in diagnosing Crohn's disease.
During these procedures, a flexible viewing tube is placed through the anus into the large intestine. An image of the inside of the intestine is often projected onto a video monitor. A sigmoidoscopy involves examining the lowest part of the large intestine. A colonoscopy can provide a view of all of the large intestine and often the end of the small intestine, which is frequently affected by Crohn's. In either case, the doctor can directly view the colon to check for signs of ulcers, inflammation, or bleeding. The doctor can also take small samples of tissue to examine under a microscope, known as a biopsy. This helps determine whether the tissue shows signs of Crohn's disease or other problems.
Diagnosing Crohn's Disease: Video Capsule Endoscopy
For video capsule endoscopy, you swallow a small capsule or pill that holds a miniature video camera. As it travels through the small intestine, it sends images of the lining to a receiver you wear on a belt around your waist. The images are downloaded and reviewed at a computer. The images can provide detailed information about early, mild problems associated with Crohn's disease. This technique may be especially helpful if you have symptoms of Crohn's disease but barium X-rays do not show evidence of the condition.
While video endoscopy can provide valuable information, there are times when it may be best to avoid it:
- If you have an obstruction in the small intestine, the capsule could get stuck and make the obstruction worse.
- If you have a narrowing in the small intestine, such as from Crohn's disease, previous surgery, or previous radiation therapy, the capsule might become stuck.
- Some doctors worry that wireless transmissions from the capsule might interfere with implanted cardiac pacemakers or defibrillators.
Making a Diagnosis of Crohn's Disease
After the exams, lab tests, and imaging tests are done, your doctor will discuss the findings with you. If your doctor believes you have Crohn's disease, then you can work together to develop a treatment plan to manage the symptoms and control the disease.