Diagnosing Crohn's Disease
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Diagnosing Crohn’s Disease

Overview

Many people won't seek treatment for Crohn's disease for months, years, or in some cases, even decades. You might ignore your symptoms because they’re so mild or even mistake them for a less serious condition such as lactose intolerance.

There aren’t any simple, definitive tests for Crohn’s disease. Talk to your doctor before trying to diagnose yourself with Crohn's. They will look for specific symptoms and perform in-depth testing to properly diagnose you.

Symptoms of Crohn's disease

Crohn's is a chronic disease, which means that symptoms may go away for a long time and then reappear during flare-ups.

Crohn's disease shares symptoms with other conditions. However, you should keep an eye on a few symptoms in particular:

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  • severe, "crampy" abdominal pain (usually shortly after eating and around the navel, lower right abdomen, or both)
  • frequent diarrhea, with or without blood
  • blood or mucus in the stool
  • frequent, urgent bowel movements
  • weight loss, usually due to discomfort after eating but sometimes because of nutritional deficiency
  • significantly increased gas
  • a persistent lack of energy
  • a firm swelling anywhere in the abdomen that is usually painful to the touch
  • perianal disease, which results in a fistula that can cause abscesses around the anus

Your doctor will take any of these symptoms into account. They’ll likely order further diagnostic tests.

Read more: Crohn’s disease symptoms »

Blood testing for Crohn’s disease

Your doctor may recommend blood tests for Crohn’s disease. These tests won’t definitively diagnose the disease, but they can point out inflammation and infections in the body. Examples of these tests include:

  • Complete blood count (CBC) measures the amount of red blood cells, white blood cells, and platelets you have in your body. A high white blood cell count could indicate possible inflammation or infection. 
  • The sedimentation rate (ESR) measures possible inflammation by testing how quickly clumps of red blood cells fall to the bottom of a test tube within an hour. The farther the clumps travel in the tube, the more intense your body’s inflammation response is at the time of the test.
  • C-reactive protein (CRP) measures possible inflammation by indicating the level of CRP in your blood. The higher the CRP level, the more intense your body’s inflammation response is at the time of the test.

Procedures to test for Crohn’s disease

Your doctor may recommend other procedures or imaging scans. These procedures can detect abnormalities in your intestines. They can also test for cell abnormalities that may indicate Crohn’s disease.

These tests can take several minutes or several days to produce results. Your doctor will also want to give you multiple tests to confirm that each test produces the same results.

It might take weeks or even months before your doctor can definitively tell you whether you have Crohn’s disease. You might also need to wait a long time between doctor’s visits and tests.

Below are some of the tests your doctor may order.

Capsule endoscopy

This test involves swallowing a small, pill-like capsule with a camera inside of it. The capsule takes photos as it travels through your gastrointestinal (GI) tract. You’ll eliminate the capsule painlessly during a bowel movement. Your doctor views the photos to find abnormalities in your intestinal lining.

Endoscopy

An endoscopy involves inserting a thin, lighted tube with a camera on the end (known as a scope) into either your esophagus or rectum. The doctor moves the scope from your mouth through your esophagus, stomach, and small intestine (EGD) (upper endoscopy) or from your rectum to the end of your entire colon (colonoscopy). Your doctor may take tissue samples from anywhere along your intestinal tract, searching for inflammation, ulcers, and granulomas. The presence of granulomas can indicate Crohn’s disease. According to Beth Israel Deaconess Medical Center, up to 20 percent of people with Crohn’s disease have granulomas.

Imaging studies

Imaging tests include CT and MRI. Both tests can help your doctor find abnormalities in your bowels like abscesses, fistulas, perforations, and signs of inflammation.

Your doctor takes these and other tests into account when determining if you have Crohn’s disease.

Diagnosing Crohn’s disease in children

Children show a lot of the same symptoms of Crohn’s disease as adults, including:

  • constant diarrhea
  • abdominal cramping or pain
  • rectal urgency
  • abnormal weight loss
  • bleeding in the intestines
  • not growing at proper rates
  • fever

Other common symptoms you might see if your child has Crohn’s:

  • red, itchy eyes
  • sores in the mouth or on the skin
  • kidney stones
  • pain or swelling in joints

If your child has these symptoms, take them to the doctor to get tested.

If your child is diagnosed with Crohn’s, your doctor may recommend medicines to help keep their Crohn’s in remission. Anti-inflammatory drugs such as sulfasalazine (Azuldifine) and mesalamine (Asacol HD) help keep flare-ups from being painful. Corticosteroids like budesonide can also help with inflammation. Immune system suppressants like azathioprine or adalimubab may help stop inflammation as well as prevent the immune system from producing chemicals that cause inflammation.

Different drugs may be prescribed based on the areas affected by Crohn’s. It’s important to get an accurate diagnosis from a doctor to decide which treatment is best.

Learn more: The five types of Crohn’s disease »

Conditions similar to Crohn's disease

Some conditions are similar to Crohn’s disease, but aren’t quite the same thing. Crohn’s disease is an inflammatory bowel disease (IBD), and its symptoms overlap with several other conditions. These include:

ConditionDescriptionSymptoms that overlap with Crohn’sPrevalence
ulcerative colitisan IBD that affects the large intestine caused by an abnormal immune systemabdominal pain or cramping, diarrhea, and abnormal weight lossin North America, occurs in 37.5 to 238 per 100,000 people
celiac diseasea condition that affects the small intestine and is caused by an inability to digest glutendiarrhea, gas, stomach cramping, and abnormal weight lossrelatively common, affecting up to 1 percent of the U.S. population
Behçet's diseasea type of vasculitis, or inflammation of the blood cellsulcers in the mouth, anus, or rectum, and a “cobblestone” look in affected areasfound in only 5.2 per 100,000 people in the United States, but much more common in countries in the Middle East and East Asia
irritable bowel syndrome (IBS)isn’t a disease and doesn’t cause any long-term damageabdominal pain, discomfort, and diarrhea due to abnormal shifts in bowel movementsaffects around 11 percent of the world population
diverticulitisa temporary condition caused by inflammation of the diverticula, small pouches in your digestive tract; can be treated with antibiotics and bowel rest abdominal pain or cramping, fever, and abnormal bowel movementsmore common in older people, affecting up to 65 percent of people over 85 but only 5 percent of people under 40
 

If you believe you might have Crohn’s, talk to your doctor about getting tested for these conditions. Some symptoms, such as inflammation in only certain areas of the digestive tract, can distinguish a condition from Crohn’s.

What to do if you’re diagnosed with Crohn’s disease

Most people with Crohn’s disease lead normal, active, and productive lives, despite the lack of a cure.

The disease itself may remain in remission for long periods. Flare-ups might only occur every few months or years. Advancements in treatments help even those with severe symptoms manage them better than ever before.

Surgical advances also make it possible to remain disease-free for years at a time.

Other effective treatment options for managing your Crohn’s and its complications include:

  • antidiarrheal medicines
  • pain relievers for pain associated with Crohn’s
  • vitamin B-12 shots to prevent vitamin deficiency
  • iron, calcium, and vitamin D supplements
  • following a special diet based on your nutritional needs (for example, eliminating dairy or fiber-rich foods, eating small meals, and drinking plenty of liquids)
  • antibiotics such as metronidazole (Flagyl) and ciprofloxacin (Cipro) to help with fistulas and abscesses

If you have Crohn’s disease, quit smoking. Some studies suggest that keeping your stress levels low helps prevent flare-ups. Light exercise can help reduce stress and depressive symptoms. It can even help keep your bowel movements regular.

Many daily choices can help you manage Crohn’s. Talk to your doctor to see what treatments will help you maintain your highest quality of life.

Read This Next

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How to Know If Your Crohn’s Is Advancing
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