How is it Diagnosed?
Inflammatory Bowel Disease (IBD), encompassing Crohn’s disease and ulcerative colitis,
is diagnosed through a combination of clinical evaluation, laboratory tests, imaging, and
endoscopic procedures.
Initial suspicion arises from symptoms such as chronic diarrhea, abdominal pain, blood in
stool, weight loss, and fatigue. A detailed history, including family history and symptom
duration, is taken.
Laboratory tests include complete blood count (to check for anemia), C-reactive protein
(CRP), and erythrocyte sedimentation rate (ESR) to assess inflammation. Fecal
calprotectin is a non-invasive stool test that helps differentiate IBD from irritable bowel
syndrome (IBS).
Definitive diagnosis requires endoscopy. Colonoscopy is the gold standard, allowing
direct visualization of mucosal inflammation, ulceration, and bleeding, along with biopsy
collection for histopathological examination. Findings such as continuous lesions are
characteristic of ulcerative colitis, while skip lesions and transmural inflammation
suggest Crohn’s disease.
Imaging studies like CT enterography, MR enterography, or small bowel follow-through
are used to detect small intestinal involvement, particularly in Crohn’s disease. Capsule
endoscopy may also be employed for visualizing the small intestine.
Serological markers like pANCA (perinuclear anti-neutrophil cytoplasmic antibody) and
ASCA (anti-Saccharomyces cerevisiae antibody) may assist in distinguishing between
ulcerative colitis and Crohn’s disease.
A multidisciplinary approach ensures accurate diagnosis, assessment of disease extent,
and guidance for treatment planning.