NewYork-Presbyterian. The University Hospital of Columbia and Cornell.

Digestive Diseases

Diagnosis of Inflammatory Bowel Disease

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Initial Tests to Diagnosis Inflammatory Bowel Disease (IBD)

Your physician will ask you to describe your symptoms, when the symptoms began, and what makes the symptoms better or worse. Next, the doctor will perform a physical exam during which he or she may look for any outward signs and symptoms of IBD such as pain when your doctor presses on areas of your abdomen, mouth sores, rashes, and abdominal masses. Your doctor may take a blood test to determine if you have anemia, a sign of potential bleeding in the intestines, or if you have high levels of white blood cells, which indicate that your body is fighting an infection and that there is inflammation somewhere in your body. In addition, a sample of your bowel movement (stool sample) may be taken to look for signs of bleeding or infection in the intestines.

X-Rays to Diagnosis Inflammatory Bowel Disease (IBD)

In order to see what is happening in your GI tract, your doctor may use a series of x-rays. One type is called an upper GI series and helps your doctor view the upper part of your GI tract, including your stomach and small intestine. For this test, you drink a liquid containing barium, a chalky white substance that coats your GI tract and allows an outline of your upper GI tract to be seen on an x-ray. Another type is called a barium enema and involves a barium solution given rectally (through your rectum or back side) and allows your doctor to view your colon on x-rays. This enema is not painful, but may be a bit uncomfortable or embarrassing because of the nature of how it is given.

Sigmoidoscopy or Colonoscopy to Diagnosis Inflammatory Bowel Disease (IBD)

The doctor may also use sigmoidoscopy or colonoscopy to view your intestines look for inflammation or bleeding. In both of these tests, your doctor will insert a thin, flexible tube into your rectum. The tube has a tiny light and camera at its end that is connected to a TV monitor, allowing your doctor a good view of your large intestine. A sigmoidoscopy is used to see the lower part of the large intestine while a colonoscopy is used to see the entire large intestine. If necessary, the doctor may take a small tissue sample (biopsy) from the lining of the intestine to look at later under a microscope. These tests are extremely helpful determining the cause of your symptoms.

In appropriate cases, sigmoidoscopies are given at the initial office visit to determine immediately what is happening in your intestines and to allow doctors to start treatment as soon as possible.

When these tests are performed without sedative medications, the patient may experience some cramping and discomfort. A sigmoidoscopy usually takes 5-10 minutes on average and a colonoscopy takes 20-30 minutes.