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Diagnosis is first suspected based on a patient's symptoms. Blood tests may reveal an increase in certain types of white blood cells, an indication that some type of inflammation is occurring in the body. The blood tests may also reveal anemia and other signs of malnutrition due to malabsorption (low blood protein; variations in the amount of calcium, potassium, and magnesium present in the blood; changes in certain markers of liver function). Stool samples may be examined to make sure that no infectious agent is causing the diarrhea, and to see if the waste contains blood.
During an endoscopic exam, a doctor passes a flexible tube with a tiny, fiber-optic camera device through the rectum and into the colon. The doctor can then carefully examine the lining of the intestine for signs of inflammation and ulceration that might suggest Crohn's disease. A tiny sample (a biopsy) of the intestine can also be taken through the endoscope, and the tissue will be examined under a microscope for evidence of Crohn's disease.
X rays can be helpful for diagnosis, and also for determining how much of the intestine is involved in the disease. For these x rays, the patient must either drink a chalky solution containing barium, or receive a barium enema (a solution that is administered through the rectum). Barium helps to "light up" the intestine, allowing more detail to be seen on the resulting x rays.
While Crohn's disease and ulcerative colitis are similar, they are also very different. Although it can be difficult to determine whether a patient has Crohn's disease or ulcerative colitis, it is important to make every effort to distinguish between these two diseases. Because the long-term complications of the diseases are different, treatment will depend on careful diagnosis of the specific IBD present.
— Rosalyn S. Carson-DeWitt
