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Diagnosis is essential to identify not only which areas of intestine are inflamed but also the severity of the lesions; this information is then used to initiate the most appropriate treatment for each patient.
Blood analysis. To detect parameters that establish the presence of inflammation, anaemia and/or infections.
Stool analysis. To diagnose concurrent infections (bacteria, parasites). There are also specific indicators that can confirm the presence of intestinal inflammation (calprotectin).
Digestive endoscopy (gastroscopy, colonoscopy). These tests are required to confirm the diagnosis, as they provide a direct view of the intestinal mucosa (innermost layer of the intestine), and to obtain biopsy samples. They are not only essential for the diagnosis of IBD, but also when monitoring the response to treatments. Colonoscopy provides a view of the colon (large intestine) and also, if necessary, the final section of the small intestine (terminal ileum). Gastroscopy is used to view the oesophagus, stomach and the most proximal section of the small intestine (duodenum).
Capsule endoscopy. This exploratory technique involves swallowing a small camera which then takes images along the entire length of the digestive tract until it is excreted through the anus. It is very useful when performing a complete study of the small intestine (segments that cannot be accessed by gastroscopy or colonoscopy).
Ultrasound. Ultrasound is a radiological technique that may be necessary in some cases to determine the location of the inflammatory process and rule out other diseases with similar symptoms (e.g., appendicitis).
Other radiological tests. Abdominal X-rays, computed tomography (CT) and/or magnetic resonance imaging (MRI) are particularly useful when it comes to diagnosing complications (stenosis, fistulas) and identifying which areas of the intestine are affected by the disease.
Imaging tests help assess any complications, complete the study of the disease’s extension and evaluate the response to treatments.
Colonoscopy is the technique of choice for the diagnosis of inflammatory bowel disease. The procedure involves a visual exploration inside the rectum, colon and terminal ileum, and can be used to obtain tissue samples from any lesions for subsequent anatomopathological study (biopsy).
The test requires that the colon is flushed by administering an evacuant the day before and/or on the same day of the test. As the introduction of air inside the colon (which is needed to obtain a clear image) causes discomfort and even pain, it is also a good idea to perform the colonoscopy with sedation.
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Substantiated information by:
Ingrid Ordas JimenezGastroenterologistGastroenterology Department
Marta Gallego BarreroNurseGastroenterology Department
Published: 20 February 2018
Updated: 4 September 2020
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