Diagnosing Crohn’s Disease

Written by Michael Kerr and Rachel Nall, RN, BSN | Published on June 15, 2015
Medically Reviewed by Healthline Medical Team on June 15, 2015

Learn the criteria, tests, and exams your doctor may use to diagnose Crohn's disease.

Overview

Many people won't seek treatment for Crohn's disease for months, years, or in some cases, even decades. Either their symptoms are mild enough to ignore, or they simply mistake them for another, less serious, condition. 

You may believe you’re suffering from conditions like lactose intolerance, irritable bowel syndrome, or an intestinal parasite, when you actually have Crohn's disease. Some people, however, don’t wait to see a doctor because their symptoms are severe and require immediate treatment. 

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There are no simple, definitive tests for the disease. It’s important to seek the opinion of a doctor before attempting to self-diagnose Crohn's. Your doctor will look for certain symptoms and may perform in-depth testing to make the proper diagnosis.

Symptoms of Crohn's Disease

Crohn's disease shares its symptoms with several other conditions and diseases, but there are a few symptoms in particular you should keep an eye on. 

Because it’s a chronic disease, Crohn's symptoms may go away for long periods of time and then re-emerge during flare-ups. You should consult a doctor if you or someone you know is experiencing one or more of the following symptoms:

  • severe "crampy" abdominal pain (usually shortly after eating and most often centered around the navel, lower right abdomen, or both)
  • frequent diarrhea (with or without blood)
  • rectal bleeding (blood and/or mucus in the stool)
  • rectal urgency (frequent, urgent bowel movements)
  • weight loss (usually due to the discomfort after eating but may be due to nutritional deficiency)
  • significantly increased gas
  • a persistent lack of energy 
  • a firm, grapefruit-sized swelling in the lower right abdomen that’s usually painful to the touch (found in about 25 percent of people with Crohn's)
  • perianal disease (a fistula which may include one or more abscesses and skin tags around the anus, that affects 25 percent of people with Crohn's)
  • children who don't grow at proper rates

Your doctor will take any symptoms you may be experiencing into account. They’ll likely consider ordering further diagnostic tests.

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 to signs of inflammation and infection in the body. Examples of tests a doctor may order include:

  • Complete blood count (CBC): This test measures how many red blood cells, white blood cells, and platelets you have in your body. A high white blood cell count could indicate possible inflammation/infection. 
  • Sedimentation rate (ESR): A test to measure possible inflammation.
  • C-reactive protein (CRP): A test to measure possible inflammation.

Procedures to Test for Crohn’s Disease

Your doctor may recommend further procedures or imaging scans to detect the possible presence of abnormalities in your intestines or for cells that could indicate the presence of Crohn’s disease. Examples of these tests include:

Capsule Endoscopy

This test involves swallowing a small, pill-like capsule that has a camera inside of it. The capsule takes photo images of your intestinal lining as it travels through your gastrointestinal (GI) tract. You’ll expel the capsule painlessly when you have a bowel movement. Your doctor can view the images the camera takes to determine if there are abnormalities in your intestinal lining.

Endoscopy

An endoscopy involves inserting a thin, lighted tube with a camera on the end (known as a scope) via your rectum. The doctor can advance the scope to the end of your large intestine (known as sigmoidoscopy) or advance it through your entire colon (known as colonoscopy). During the procedure, your doctor may take tissue samples from your colon to test for cells called granulomas. The presence of these cells can indicate Crohn’s disease. According to Beth Israel Deaconess Medical Center, 20 percent of people with Crohn’s disease have these cells.

Imaging Studies

Imaging tests include computed tomography (CT) and magnetic resonance imaging (MRI). Both tests can help your doctor detect abnormalities around the bowel area.

Radiology Testing

A test known as a small bowel imaging or upper GI series can help your doctor evaluate your small intestine for the presence of abnormalities and known Crohn’s disease complications, such as abscesses, fistulas, and perforations.

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

What to Do If You’re Diagnosed with Crohn's Disease

Don't panic. Although there is currently no cure for Crohn's disease, most people with the illness lead relatively normal, active, and productive lives.

The disease itself may remain in remission for long periods, with flare-ups only occurring every few months or years. Advancements in treatments can help even those with the most severe cases of Crohn's manage their symptoms better than ever before. 

Surgical advances also allow some people to remain disease-free for years at a time. It’s important to note that a diagnosis of Crohn's is not a death sentence. It may even help you regain or re-evaluate your life.

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