To diagnose Crohn's disease, the doctor will usually want to rule out other possible causes for the symptoms, such as colorectal cancer and diverticulitis. The following procedure and tests can be used to confirm the diagnosis:
Barium Enema
The entire large intestine may be examined using a barium enema (an X-ray of the bowel). A white liquid called barium is placed into the bowel by enema, where it fills and coats the lining of the bowel, creating a silhouette of the rectum, colon and a portion of the small intestine. Barium acts as a contrast dye and so enables the specialist to view the bowel on an X-ray screen to identify any irregularities.
Blood Tests
The doctor will run tests to check the blood for anaemia, signs of malabsorption of vitamin B12 and lack of protein and folic acid. They may also test the blood for the presence of certain antibodies, which may help to diagnose the exact type of inflammatory bowel disease.
Flexible Sigoidoscopy
In this procedure, the doctor passes an instrument known as a sigmoidoscope into the rectum and sigmoid (the last 60 cm of the colon). This flexible, lighted tube transmits an image of the inside of the rectum and colon, so that the doctor can carefully examine the lining of these organs for signs of inflammation or ulceration. The tube also blows air into these organs, which inflates them and helps the doctor to see them more clearly.
Although this test may be somewhat uncomfortable, it should only take a few minutes to complete.
Colonoscopy
This procedure is somewhat similar to flexible sigmoidoscopy, but can allow the doctor to examine the entire length of the colon. Before the test can be performed, the colon must be free of solid matter. The patient must follow a low fibre or clear fluid diet for 1-3 days before the procedure, then on the day before the colonoscopy, they are usually given a laxative preparation to clean out the colon.
Before the procedure starts, patients may be given a mild sedative to make them more comfortable. A long, slender, flexible tube attached to a video camera and monitor (known as a colonoscope) is passed into the rectum and used to view the entire colon and rectum. The bowel is occasionally insufflated with air to maximise visibility. The doctor may take tissue samples (biopsies) for analysis during this procedure. Major risks of colonoscopy include haemorrhage and perforation of the colon wall; however, these are rare.
Other Tests
Other tests may include a computerized tomography (CT) scan, which can be used to pinpoint the location and extent of the affected area, or to check for complications such as abscesses, partial blockages or fistulas.
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