Overview
Most people diagnosed with Crohn’s first see a healthcare provider because of ongoing diarrhea, belly cramping or unexplained weight loss. As part of your workup, you may need to see a doctor who specializes in digestive diseases, called a gastroenterologist.
Your provider will consider your medical history (including your symptoms) and family history. They’ll perform a physical exam to see if you have signs of Crohn’s like swelling or tenderness in your belly. They may perform a series of tests to rule out other conditions before making a diagnosis.
Lab tests
Lab tests check a sample of fluid or tissue for microscopic signs of disease.
- Blood test: A blood test checks your blood cell counts and blood chemistry for signs of Crohn’s. A high white blood cell count may indicate inflammation or infection. Low levels of red blood cells indicate anemia, common with Crohn’s disease. A protein your liver makes called the C-reactive protein (CRP) may be elevated if there’s active inflammation.
- Stool test: This test checks a stool (poop) sample for bacteria or parasites. It can rule out infections that cause chronic diarrhea. For example, a calprotectin fecal test measures inflammation in your intestines.
Imaging procedures
Your provider may order imaging tests to take pictures of your digestive tract, such as:
- Computed tomography (CT) scan: A CT scan creates images of your digestive tract using X-rays. It tells your healthcare provider how severe the inflammation is. You may need a CT enterography, which involves drinking a solution that highlights your small intestine so it stands out more in the images.
- Magnetic resonance imaging (MRI): An MRI uses a large magnet and radio waves to create images of the inside of your body. It’s especially useful in showing fistulas around your small intestine and anus. You may need to drink a special contrast fluid before the procedure to clarify the images (MRI enterography).
Endoscopy
An endoscopy sends a thin tube with a light and camera (endoscope) into your digestive tract to take images or show videos of areas with inflammation. You’ll be sedated for these procedures.
- Colonoscopy: During this procedure, a provider uses an endoscope to examine the inside of your colon and lower small bowel (ileum). They may remove a tissue sample (biopsy) to test for white blood cells.
- Upper endoscopy: A provider passes an endoscope through your mouth and into your throat. An attached camera allows your provider to see inside, from your mouth to the start of your small intestine.
- Capsule endoscopy: You swallow a small plastic capsule with a light and a camera that takes pictures as it moves through your digestive tract.
Symptoms
When to see a doctor
Complications
- High blood pressure.
- Diabetes.
- Heart failure.
- Some types of heart valve disease.
Prevention
- Control high blood pressure, high cholesterol and diabetes.
- Don't smoke or use tobacco.
- Eat a diet that's low in salt and saturated fat.
- Exercise at least 30 minutes a day on most days of the week unless your health care team says not to.
- Get good sleep. Adults should aim for 7 to 9 hours daily.
- Maintain a healthy weight.
- Reduce and manage stress.
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