Diagnosing Ulcerative Colitis
The doctor will make a diagnosis based on medical history, a physical examination and a series of tests. The first goal of these tests is to differentiate Ulcerative Colitis from infectious causes of diarrhea. The MD will conduct a physical exam and interview the patient to learn more about their general health, diet, family history and environment. Blood and fecal matter will be tested. Stool specimens are analyzed to eliminate the possibility of bacterial, viral, or parasitic causes of diarrhea. Blood tests can check for signs of infection as well as for anemia, which may indicate bleeding in the colon or rectum. Following this, the patient generally undergoes an evaluation of the colon, using one of two tests -- a sigmoidoscopy or total colonoscopy with biopsies.
The doctor may recommend two types of endoscopic examinations: a sigmoidoscopy and a total colonoscopy. Sigmoidoscopy/Colonoscopy involves the insertion of a scope into the rectum and lower colon to allow visualization to the extent and degree of inflammation in these areas. A colonoscopy may be utilized to look for any polyps or pre-cancerous changes in the setting of colitis. Chromoendoscopy is a technique of spraying a blue liquid dye during the colonoscopy in order to increase the ability of the endoscopist to detect slight changes in the lining of the intestine. The technique may identify early or flat polyps which can be biopsied or removed.
Since Crohn's Disease is patchy in nature and can affect any portion of the bowel, many physicians will try to evaluate the terminal ileum to ensure disease isn’t in the small bowel before making a diagnosis of Ulcerative Colitis. If an ileocolonoscopy is negative, some literature suggests that further evaluation of the small bowel be investigated to rule out Crohn's Disease due to similarities of both IBD sub-types.
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