Digestive Health Inflammatory Bowel Disease Diagnosis IBD Guide IBD Guide Overview Symptoms Diagnosis Treatment How Inflammatory Bowel Disease Is Diagnosed By Amber J. Tresca Amber J. Tresca Facebook LinkedIn Twitter Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16. Learn about our editorial process Updated on November 03, 2022 Medically reviewed by Shadi Hamdeh, MD Medically reviewed by Shadi Hamdeh, MD Shadi Hamdeh, MD, is a board-certified gastroenterologist and an assistant professor of medicine at the University of Kansas Medical Center. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Self-Checks Labs and Tests Imaging and Procedures Differential Diagnoses Frequently Asked Questions Next in IBD Guide How Inflammatory Bowel Disease (IBD) Is Treated Accurately diagnosing inflammatory bowel disease (IBD) can be challenging. Its symptoms, such as abdominal pain and diarrhea, can mimic those of other gastrointestinal conditions, which must first be ruled out before reaching an IBD diagnosis. A patient history, bloodwork, and diagnostic imaging may all be used to aid in this process. Tests are also used to distinguish between the different forms of IBD: Crohn’s disease, and ulcerative colitis. All of this can take some time. As such, it's important to see your healthcare provider as soon as possible for an evaluation if you're experiencing gastrointestinal issues consistent with IBD. Getting the right diagnosis as soon as possible can help you start proper treatment so you can start feeling better. For severe symptoms (e.g., significant abdominal pain, substantial bleeding), seek immediate medical attention. Self-Checks You can't conduct any at-home testing that will confirm IBD. But keeping a detailed diary of symptoms can be useful to your healthcare provider and helpful in identifying patterns that may hint at a diagnosis. Verywell / Alex Dos Diaz The first clues are often the following symptoms, so be sure to note: Unrelenting diarrhea Blood and/or mucus in the stool (more common with ulcerative colitis than Crohn’s disease) Fever Abdominal pain Also log instances of other gastrointestinal symptoms, such as: VomitingFatigueHeadachesWeight loss Bring your notes to your healthcare provider's appointment. Reviewing them may prompt your healthcare provider to refer you to a gastroenterologist, a physician who specializes in the digestive tract. Labs and Tests Your healthcare provider will decide the right tests for you based on your medical history, family history, and symptoms. Tests will be done to rule out other illnesses, but may also be done to test for conditions that sometimes occur along with IBD, such as arthritis. Complete Blood Count (CBC) A CBC includes a check of the white blood cell (WBC) count and the red blood cell (RBC) count. A high WBC count may be a sign that there is inflammation somewhere in the body. A low RBC count could be a sign of internal bleeding. Subsequent RBC counts are also used to measure blood loss. Fecal Occult Blood Test A fecal occult blood test (also called stool guaiac or hemoccult test) is used to examine stool for traces of blood that can not be seen with the naked eye. Stool may also be tested for the presence of a bacterial infection that could cause symptoms. Electrolyte Panel An electrolyte panel measures levels of sodium, potassium, chloride, and carbon dioxide in the body. Chronic diarrhea may cause these electrolytes to get to abnormally low levels. Liver Function Tests Liver function tests (LFTs) measure alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), albumin, total protein, and total and direct bilirubin levels. Abnormal levels may be caused by malnutrition stemming from the gastrointestinal tract not absorbing nutrients properly. Imaging and Procedures Depending on the symptoms and the suspected cause of the problem, a combination of the following studies may be ordered. The results will be examined to see if they fit with a diagnosis of a form of IBD or a different condition. X-Rays X-rays are quick, relatively inexpensive, and non-invasive. Abdominal X-rays can show if the bowel is narrowed, obstructed, or dilated. Barium Enema A barium enema (also called a lower gastrointestinal series) is a special type of X-ray that uses barium sulfate and air to outline the lining of the rectum and colon. The results can show polyps, tumors, or diverticulosis. Upper GI Series An upper gastrointestinal (upper GI) series is a type of X-ray used to examine the esophagus, stomach, and duodenum (the first section of the small intestine). It is sometimes used to examine more of the small intestine. Sigmoidoscopy A sigmoidoscopy is an endoscopic procedure that is used to examine the last third of the large intestine, which includes the rectum and sigmoid colon. This test can be used to check for cancer, abnormal growths (polyps), inflammation, and ulcers. Colonoscopy A colonoscopy is an endoscopic procedure used to examine the inside of the colon and can go beyond the areas a sigmoidoscopy can reach. A colonoscopy is useful in detecting colon cancer, ulcers, inflammation, and other problems in the colon. Biopsies can also be taken during a colonoscopy and examined in a lab for additional clues. Upper Endoscopy An upper endoscopy is used to see inside the esophagus, stomach, and duodenum. It may be used to find the source of swallowing problems, nausea, vomiting, reflux, bleeding, indigestion, abdominal pain, or chest pain. Differential Diagnoses Given that some of the classic symptoms of IBD are, generally speaking, vague, your healthcare provider will not immediately jump to a conclusion of IBD. Among the other concerns that they will consider and work to rule out are: Parasitic infection Diverticulitis Celiac disease Colon cancer A Word From Verywell Seeing an IBD specialist may be the best way to go if you feel strongly about your symptoms but have not yet gotten a diagnosis. For some, this could mean traveling to see a healthcare provider at an IBD center and, possibly, paying out-of-pocket. Neither of these things is desirable or, in some cases, possible. But getting the right diagnosis in a timely manner so that treatment can begin is important in the effective management of IBD. At the very least, consider seeking a local second opinion. Frequently Asked Questions How does IBD pain feel? Depending on the type of condition, IBD pain can feel like cramping in different areas of the abdomen, severe abdominal pain, or slight discomfort. For example, cramps in the middle of the abdomen or the lower right side indicates Crohn's disease whereas rectal pain is indicative of ulcerative colitis. How is IBD treated? IBD treatment varies depending on the specific condition but may involve biologics, corticosteroids, and immunomodulators to reduce intestinal inflammation and manage flare-ups. Over-the-counter medications can also be helpful and may include antidiarrheals, NSAIDS, and probiotics. As a last treatment option when medication is no longer helping, surgical treatment may be considered to remove diseased sections of the bowel or colon. How Inflammatory Bowel Disease (IBD) Is Treated 7 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Wehkamp J, Götz M, Herrlinger K, Steurer W, Stange EF. Inflammatory Bowel Disease. Dtsch Arztebl Int. 2016;113(5):72–82. doi:10.3238/arztebl.2016.0072 Fakhoury M, Negrulj R, Mooranian A, Al-Salami H. Inflammatory bowel disease: clinical aspects and treatments. J Inflamm Res. 2014;7:113–120. Published 2014 Jun 23. doi:10.2147/JIR.S65979 Vavricka SR, Schoepfer A, Scharl M, Lakatos PL, Navarini A, Rogler G. Extraintestinal Manifestations of Inflammatory Bowel Disease. Inflamm Bowel Dis. 2015;21(8):1982–1992. doi:10.1097/MIB.0000000000000392 Mohammadi R, Hosseini-Safa A, Ehsani Ardakani MJ, Rostami-Nejad M. The relationship between intestinal parasites and some immune-mediated intestinal conditions. Gastroenterol Hepatol Bed Bench. 2015;8(2):123–131. Crohn's & Colitis Foundation. Overview of Crohn's disease. Crohn's & Colitis Foundation. Types of ulcerative colitis. Cleveland Clinic. Inflammatory bowel disease (overview). Additional Reading Cleveland Clinic. Inflammatory Bowel Disease. Crohn's and Colitis Foundation of America. Diagnosing Crohn's Disease and Ulcerative Colitis. UC San Diego, Division of Gastroenterology. Inflammatory Bowel Disease. By Amber J. Tresca Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit