Crohn’s Disease Diagnosis |
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As diseases go, Crohn’s is one of the more straight-forward to diagnose. Severe abdominal cramping combined with blood streaked stools that lasts for several days are the obvious earmarks of an intestinal disorder.
Of course, figuring out which intestinal disorder is a little bit harder, and then pin-pointing Crohn’s specifically is more difficult still.
A visit to the doctor will likely suggest several possibilities. The symptoms listed above could be any one of the following:
- Bacterial or viral infection
- Appendicitis
- Irritable Bowel Syndrome (IBS)
- Inflammatory Bowel Disease (IBD)
Initial Steps
In order to determine what he or she is dealing with, the doctor begins with a physical exam. After determining the clinical symptoms, the doctor will request a blood panel to decide if there is a bacterial or viral component to the malady.
An increase in the white blood cells would indicate an infection, which would generally suggest a bacterial or viral infection, though it doesn’t necessarily rule out IBD. A stool sample will also be collected so that the characteristics and the amount of blood can be concluded.
When combined with the clinical evaluation, these tests can be used to get a clearer picture of what is happening to the patient’s body.
Advanced Tests
The initial testing can close the gate on some possibilities, but with so many out there, additional testing is necessary to narrow the field even further.
A barium x-ray is considered by many gastroenterologists to be the least invasive of the next level of testing while still being one of the best. A barium dye is swallowed by the patient before going in for extensive x-rays of the abdomen. The dye allows the intestines to be fully visible on the film, giving the radiologist a clear picture of what’s happening inside.
During the early stages of Crohn’s disease, there would be little difference in appearance between it and other types of IBD. If caught early enough, the ulcers won’t have had time to eat through more than the first layer of the intestinal lining.
Determining Crohn’s from IBD
Some doctors will request a more invasive procedure called an endoscopic exam. This exam involves a long, flexible piece of plastic tubing with a camera attached to the end. This is threaded through the intestines to give the doctor a clear, unobstructed view of the intestinal lining.
The endoscopy can usually differentiate the diagnosis of Crohn’s from IBD due to the extent of the disease. In the earliest stages of Crohn’s, it’s not unusual for it to be misdiagnosed as IBD. Approximately 10% of patients are never able to determine if they have ulcerative colitis or Crohn’s, which can lead to greater problems down the road.
Sometimes, in order to determine the extent of the damage, the doctor will order a C-T scan – sometimes called a CAT scan – with barium dye. This will give a very in-depth picture of the intestines from mouth to anus, allowing the doctor to see where active and potential trouble may be.
Experience Matters
All of these tests may be used to determine a diagnosis, or only a few may be needed, depending on the extent of the damage. Additionally, a doctor’s experience with Crohn’s will help guide him to a diagnosis quicker and with less testing.
In the end, a diagnosis of Crohn’s is not likely to be a quick, simple office visit. Even the most experienced physicians will require some tests to be certain that their guess is correct. Knowing what to expect will go a long way in alleviating any concerns the patient may have.
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