Inflammatory Bowel Disease
How is IBD Diagnosed?
Your doctor makes the diagnosis of inflammatory bowel disease based on your symptoms and various exams and tests:
- Stool exam. You'll be asked for a stool sample that will be sent to a laboratory to rule out the possibility of bacterial, viral, or parasitic causes of diarrhea. In addition, the stool will be examined for traces of blood that cannot be seen with the naked eye.
Complete blood count. A nurse or lab technician will draw blood, which will then be tested in the lab. An increase in the white blood cell count suggests the presence of inflammation. And if you have severe bleeding, the red blood cell count and hemoglobin level may decrease.
- Barium X-ray. To check the upper gastrointestinal (GI) tract, you will be given a chalky white solution containing barium to swallow. The barium will coat the inside of the intestinal tract so it will be visible on X-rays. If you have abnormalities caused by Crohn's disease in the upper GI tract, which includes your esophagus, stomach, and small intestine, they will show up. To check the lower GI tract, you will be given an enema containing barium and asked to hold it in while X-rays are taken of the rectum and colon. Abnormalities caused by either Crohn's or ulcerative colitis will show up in these X-rays.
- Sigmoidoscopy. In this procedure, a doctor uses a sigmoidoscope, which is a narrow, flexible tube with a camera and light to visually examine the last one-third of your large intestine, which includes the rectum and the sigmoid colon. The sigmoidoscope is inserted through the anus and the intestinal wall is visually examined for ulcers, inflammation, and bleeding. The doctor may also take samples -- biopsies -- of the intestinal lining with an instrument inserted through the tube. These will then be examined in a laboratory under a microscope.
Colonoscopy. A colonoscopy is similar to a sigmoidoscopy, except that the doctor will use a colonoscope, which is a longer flexible tube, to examine the entire colon.
Upper endoscopy. If you have upper GI symptoms such as nausea and vomiting, a doctor will use an endoscope -- a narrow, flexible tube with a camera and light that will be inserted through the mouth -- to examine your esophagus, stomach, and duodenum, which is the first part of your small intestine. Ulceration occurs in the stomach and duodenum in up to one out of every 10 people with Crohn's disease.
How Is Inflammatory Bowel Disease Treated?
Treatment for IBD involves a combination of self-care and medical treatment.
Although no specific diet has been shown to prevent or treat IBD, dietary changes may be helpful in managing your symptoms. It's important to talk with your doctor about ways to modify your diet while making sure you get the nutrients you need. For instance, depending on your symptoms, the doctor may suggest that you reduce the amount of fiber or dairy products that you consume. Also, small, frequent meals may be better tolerated. In general, there is no need to avoid certain foods unless they cause or worsen your symptoms.