Diagnosing Crohn’s Disease

As symptoms caused by Crohn’s disease can represent different problems, in many circumstances the first step a doctor may take will be to order a stool sample to find out if they are being caused by an infection. The stool may also contain certain chemicals that will help to show if Crohn’s disease could be the cause (fecal calproctectin).

A blood test may help to show if there is inflammation of the intestine (CRP, or ESR). The doctor will also look inside the digestive system using a long tube called and colonoscope. Colonoscopy lets the doctor see any inflammation or ulcers caused by Crohn’s disease.

Other tests that may be done to help the diagnosis are a barium enema, capsule endoscopy (a pill containing a very small camera that takes pictures of the small intestine), computerized tomography (usually called a CAT scan), magnetic resonance imaging (known as MRI), or ultrasound.

In order to decide how to treat a patient with Crohn’s disease, the doctor needs to know which parts of the digestive system are affected and how severe the disease is. This is done partly from what is seen during colonoscopy and other imaging tests, and partly based on the patient’s symptoms and how badly the symptoms affect their quality of life. The disease can then be placed into one of several categories based on symptoms and the impact these symptoms has in their life:

Diagnosis for Chron’s disease

Though it seems to make sense the severity of symptoms should allow one to decide how severe one’s Crohns disease is, this in fact does not seem to be the best approach. Over the past decade it has be proven that the severity of symptoms does not tell us how much damage the bowels are experiencing due to Crohns disease.

Because this relationship is so poor simply responding to symptoms has not reduced the risk of serious problems relating to Crohn’s including surgery and hospitalization. Very interestingly if one changes their approach and instead focuses on healing the bowel (mucosal healing) then indeed the risk of surgery and other potential problems caused by Crohn’s disease can be reduced.