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 mild or you may mistake them for a less serious condition, such as lactose intolerance or other food sensitivity.
There aren’t any simple, definitive tests for Crohn’s disease. Talk to your doctor before trying to diagnose yourself with Crohn’s. They’ll look for specific symptoms and perform in-depth testing to diagnose you properly.
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 several other conditions. However, you should keep an eye on these symptoms in particular:
- severe, crampy abdominal pain around the navel or right lower abdomen, or both (usually shortly after eating)
- frequent diarrhea, with or without blood
- blood or mucus in the stool
- frequent, urgent bowel movements
- weight loss due to nutritional deficiency
- decreased appetite to avoid symptoms after eating
- significantly increased gas
- a persistent lack of energy
- a firm swelling anywhere in the abdomen, usually painful to the touch
- inflammation, pain, bleeding, or pus around the anus
If you have any of these, your doctor will likely order further diagnostic tests.
Your doctor may recommend various procedures or imaging scans to test for Crohn’s disease. 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 give you multiple tests to confirm that results are consistent. It might be weeks or months before your doctor can tell you whether you have Crohn’s disease.
Below are some of the tests your doctor may order.
Your doctor may recommend blood tests for Crohn’s disease. These tests won’t diagnose the disease, but they can detect inflammation in the body. Inflammation can be caused by infections or it can have other causes. Examples of these tests include:
- Complete blood count (CBC): This test measures the amount of red blood cells, hemoglobin, white blood cells, and platelets you have in your body. A high white blood cell count could indicate inflammation.
- Sedimentation rate (ESR) test: This looks for inflammation by testing how quickly red blood cells clump together and fall to the bottom of a test tube within an hour. The faster the red blood cells travel to the bottom of the tube and form sediment, the more intense your body’s inflammatory response is at the time of the test.
- C-reactive protein (CRP) test: This protein, produced by the liver, is a marker of inflammation. The higher the CRP level in your blood, the more inflammation there is in your body at the time of the test.
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 eliminate the capsule painlessly during a bowel movement.
Your doctor views the photos to find abnormalities in your intestinal lining.
An endoscopy involves inserting a thin, lighted, fiberoptic scope with a camera on the end into either your esophagus or anus. In an EGD, or upper endoscopy, the doctor moves the scope from through your mouth into your esophagus, stomach, and small intestine.
In a colonoscopy, they move the scope through your anus and up into the rest of your colon.
Your doctor may take tissue samples from anywhere along your GI tract, searching for inflammatory changes such as ulcers, cancerous tumors, or granulomas.
Granulomas are clusters of immune cells, and they’re more likely to be found in younger patients, and those with more significant disease and more symptoms.
Imaging tests include CT and MRI scans. Both tests can help your doctor find abnormalities in your bowel, such as abscesses, fistulas, perforations, and signs of inflammation. Your doctor will consider the results of these and other tests when determining if you have Crohn’s disease.
Children show many 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
Other symptoms you might see if your child has Crohn’s include:
- red, itchy eyes
- sores in the mouth or on the skin
- kidney stones
- pain or swelling in joints
- stunted growth
If your child has any of these symptoms, see a doctor for testing.
If your child is diagnosed with Crohn’s, your doctor may recommend medication to help keep their Crohn’s in remission.
Corticosteroids such as budesonide can also help with inflammation but should only be used short term in children because of side effects.
Other immune system suppressants such as azathioprine or adalimumab may help reduce inflammation and 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 to decide which treatment is best.
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:
|Condition||Description||Signs and symptoms that overlap with Crohn’s||How common|
|ulcerative colitis||an IBD that affects only the large intestine, caused by an abnormal immune system response||abdominal pain or cramping, diarrhea, and abnormal weight loss||in North America, occurs in 37.5 to 238 per 100,000 people|
|celiac disease||a malabsorption condition that affects the small intestine and is caused by an inability to digest gluten and where the immune system reacts abnormally||diarrhea, gas, stomach cramping, and abnormal weight loss||relatively common, affecting up to 1 percent of the U.S. population|
|Behçet’s disease||a disease of vasculitis (inflammation of the blood vessels) that happens throughout the body||ulcers in the mouth, anus, or rectum; (rarely) a “cobblestone” look in affected areas||found in only 5.2 per 100,000 people in the United States, but much more common in countries in East Asia and the Middle East|
|irritable bowel syndrome (IBS)||isn’t a disease, per se, and typically doesn’t cause any long-term damage||abdominal pain, discomfort, and diarrhea alternating with constipation due to abnormal shifts in bowel movements||affects around 11 percent of the world’s population|
|diverticulitis||a condition caused by inflammation of the diverticula, small tubular pouches in your digestive tract; can be treated with antibiotics and bowel rest||abdominal pain or cramping, fever, and abnormal bowel movements||more common in people over 40, in women, and in white people, an estimated 88 per 100,000 people are hospitalized for the condition|
If you think you might have Crohn’s disease, talk to your doctor about getting tested for these other conditions. Some symptoms or signs, such as inflammation in only certain areas of the digestive tract, can distinguish other conditions from Crohn’s.
With effective therapy, Crohn’s can 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 the disease 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 medication (shop for these medications online)
- 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, eating small meals, and drinking plenty of liquids)
- antibiotics such as metronidazole (Flagyl) and ciprofloxacin (Cipro) to help treat bacterial infection and possible related fistulas and abscesses
- medications that suppress your immune system and decrease inflammation, such as immunomodulators or biologic drugs
If you have Crohn’s disease, quit smoking tobacco. Also, keeping your stress levels low helps prevent flare-ups. Light exercise can help reduce stress and depressive symptoms. It can help keep your bowel movements regular as well.
Lots of daily lifestyle choices can affect your Crohn’s disease. Talk to your doctor to see what simple changes along with treatments can help you have the best quality of life.