How to Get a Diagnosis of IBD

If You Suspect Crohn's Disease or Ulcerative Colitis, What Should You Do?

Doctor & Patient
When you think you have IBD, there can be a lot of things swirling through your head. Take things one step at a time to proceed towards diagnosis and treatment. Image © Getty Images

If you think you have inflammatory bowel disease (IBD), the first thing you should do is get an accurate diagnosis to make sure. It will take time, and you may need several doctor visits and tests. That's because many other conditions can cause the same symptoms as IBD. Once you get a diagnosis, then you can treat it properly.

To determine the cause of your symptoms:

  • Compare symptoms with those typical of IBD
  • Keep symptom and food logs
  • Discuss logs with physician
  • See a digestive specialist
  • Undergo testing to determine cause of symptoms
  • Begin treatment

If your symptoms are severe, are causing you significant stress or are incapacitating, see a physician as soon as possible. If you have severe abdominal pain, significant bleeding or suspected dehydration, seek immediate medical attention.

What IBD Is -- And Isn't

IBD is an autoimmune, incurable and chronic disease. It has two main forms: Crohn's disease and ulcerative colitis. Symptoms can include blood in the stool, abdominal pain and diarrhea. IBD should not be confused with other similarly named conditions, such as colitis or irritable bowel syndrome (IBS). Colitis is any inflammation of the colon, regardless of the cause. IBS is a gastrointestinal disorder where the colon has no disease such as ulcers or inflammation.

Do I Need A Specialist?

If think you have IBD, keep a log of your digestive symptoms, and any other related symptoms such as vomiting, fatigue, headaches and weight loss. Logs are more effective than memory in describing your symptoms to your physician. Plus, patterns in your symptoms will become apparent on paper.

Next, bring your logs to your family physician or internist who can help you determine if you need to see a gastroenterologist, a physician who specializes in the digestive tract.

How Do I Get a Diagnosis?

A gastroenterologist will take a history of any IBD symptoms and conduct some tests. Tests may also be used to rule out other possible digestive disorders and diseases. Depending on your symptoms, you may be tested for conditions that tend to occur along with IBD, such as arthritis. Any combination of the tests below, or other tests that are not listed here, may be used to make a diagnosis.

  • Complete Blood Cell (CBC) Count. A CBC count is several different tests that are run on the blood, including white and red blood cell counts.
  • Rectal exam. During a rectal exam, the doctor inserts a lubricated, gloved finger into the rectum to feel for abnormal areas and check for bleeding.
  • Stool culture. A stool culture may be used to rule out other causes for diarrhea, such as a bacterial infection or parasitic infection.
  • Sigmoidoscopy. During a sigmoidoscopy, the doctor will examine the last third of the large intestine, which includes the rectum and sigmoid colon, with a sigmoidoscope, a flexible viewing tube.
  • Colonoscopy. A colonoscopy can examine the inside of the colon beyond the areas a sigmoidoscopy can reach. This test uses a colonoscope--a flexible tube with lenses, a tiny TV camera and a light at the end.

Beginning Treatment

If the diagnosis is IBD, your physician will devise a treatment plan. Treatment may include dietary and lifestyle changes, medication or complementary therapies. In some cases, you may be treated with surgery.

  • Dietary changes. No specific diet is recommended for IBD. However, some people find that certain foods exacerbate their symptoms including high fiber, greasy or fried foods, dairy products, raw fruits and vegetables, and alcohol. Other foods known to cause gastrointestinal symptoms include artificial sweeteners or sugar substitutes, artificial fat (olestra), carbonated beverages and coffee.
  • Lifestyle changes. Stress doesn't cause IBD, but it can worsen it. Eliminating stressful situations and controlling stress may help. A physician may also recommend quitting smoking and regular exercise.
  • Medications. Many medications that may be used to treat IBD symptoms. Some people may have to try several drugs before finding one that helps symptoms. Unfortunately, no drugs will cure IBD. The type of drug therapy used will depend upon the form of IBD (Crohn's disease or ulcerative colitis) and the severity and location of the disease.
  • Complementary therapy. Complementary therapies can include anything from nutritional supplementation to support groups. Some supplements that may affect IBD include fish oil, chamomile, aloe vera, butyrate, and boswellia.

    Be sure to keep your regular doctor informed about your visits to your gastroenterologist, as well as any other specialists or health-care providers you see.

    View Article Sources
    • Crohn's and Colitis Foundation of America. "Diagnosing Crohn's Disease and Ulcerative Colitis." 2007. 
    • National Digestive Diseases Information Clearinghouse. "Crohn's Disease." February 2006. National Institute of Diabetes and Digestive and Kidney Diseases.
    • National Digestive Diseases Information Clearinghouse."Ulcerative Colitis." February 2006. National Institute of Diabetes and Digestive and Kidney Diseases.