To help confirm a diagnosis of IBD, you may have one or more of the following tests and procedures:
- Tests for anemia or infection. Your doctor may suggest blood tests such as complete blood count to check for anemia (too few red blood cells) and infection.
- Fecal occult blood test. This detects any hidden blood in stool.
- Colonoscopy. This test allows your doctor to view your entire colon using a thin, flexible, lighted tube with an attached camera.
- Flexible sigmoidoscopy. In this procedure, your doctor uses a slender, flexible, lighted tube to examine the last section of your colon (sigmoid).
- Upper endoscopy. In this procedure, your doctor uses a slender, flexible, lighted tube to examine the esophagus, stomach and first part of the small intestine (duodenum).
- Capsule endoscopy. This test is used to help diagnose Crohn’s disease.
- Double-balloon endoscopy. For this test, a longer scope is used to look further into the small bowel where standard endoscopes don’t reach.
- X-ray. If you have severe symptoms, your doctor may use a standard X-ray of your abdominal area to rule out serious complications, such as a perforated colon.
- Computerized tomography (CT) scan. You may have a CT scan — a special X-ray technique that provides more detail than a standard X-ray does. This test looks at the entire bowel as well as at tissues outside the bowel. CT enterography is a special CT scan that provides better images of the small bowel. This test has replaced barium X-rays in many medical centers.
- Magnetic resonance imaging (MRI). MRI is particularly useful for evaluating a fistula around the anal area (pelvic MRI) or the small intestine (MR enterography). Unlike CT, there is no radiation exposure with MRI.
- Small bowel imaging. This test looks at the part of the small bowel that can’t be seen by colonoscopy.
Medicines usually are the treatment of choice for IBD. They can control or prevent inflammation in the intestines and help to:
- Relieve symptoms.
- Promote healing of damaged tissues.
- Put the disease into remission and keep it from flaring up again.
- Postpone the need for surgery.
The choice of medicine usually depends on how severe the disease it, what part of the intestine is affected, and whether complications are present. Medicines for Crohn’s disease include:
- Aminosalicylates (such as mesalamine or sulfasalazine). These medicines help manage symptoms.
- Antibiotics (such as ciprofloxacin or metronidazole). These may be tried if aminosalicylates aren’t helping. They are also used to treat fistulas and abscesses.
- Corticosteroids (such as budesonide or prednisone). These steroid medicines usually stop symptoms and put the disease in remission.
- Medicines that suppress the immune system (such as azathioprine and methotrexate). You may take these if the medicines listed above don’t work, if your symptoms come back when you stop taking steroid medicines, or if your symptoms come back often, even with treatment.
- Biologics (such as infliximab or adalimumab). Your doctor may have you try these medicines if other medicines for Crohn’s disease haven’t worked for you. In some cases, biologics are tried before some of the other medicines listed above. They are also used to treat fistulas.
- Cyclosporine and intravenous (IV) corticosteroids, which may be needed for severe cases.