Ulcerative Colitis

 

Ulcerative colitis can be relatively easy to diagnose because it normally affects only the colon and rectumClick here to see an illustration. and usually causes an obvious change in daily bowel habits, such as frequent stools containing blood or mucus. Your doctor will conduct a medical history and physical exam before doing other tests.

The colon and rectum can be examined with flexible sigmoidoscopy or colonoscopy, tests in which a doctor examines the inside of the large intestine using a small, lighted scope. In general, colonoscopy is the preferred test because it can be used to examine the entire colon. But flexible sigmoidoscopy may be all that is needed to diagnose ulcerative colitis. Both procedures can be used to take a sample (biopsy) of intestinal tissue. The diagnosis of ulcerative colitis is made by ruling out other causes of diarrhea and assessing the results of these tests.

Other exams and tests that may be used to evaluate ulcerative colitis include:

  • Abdominal X-ray, which provides a picture of structures and organsClick here to see an illustration. in the abdomen.
  • Barium enema, a test that allows the doctor to examine the large intestine (colon).
  • Computed tomography (CT) scan, which uses X-rays to produce detailed pictures of structures inside the body.
  • Magnetic resonance imaging (MRI), which uses a magnetic field and pulses of radio wave energy to provide pictures of organs and structures inside the body.
  • Stool analysis (including a test for blood in the stool), to look for blood, signs of bacterial infection, parasites, or the presence of white blood cells.
  • Standard blood and urine tests, to check for anemia, inflammation, or malnutrition. Depending on the symptoms, an erythrocyte sedimentation rate (ESR, or sed rate) or a C-reactive protein (CRP) blood test may be done to look for infection or inflammation.
  • Biopsy of a sample of tissue from the lining of the intestine. Biopsies are collected during sigmoidoscopy or colonoscopy to confirm the diagnosis of ulcerative colitis. A biopsy also may be done to find out whether a tumor is present. Multiple biopsies are often done to screen for cancer in people who have had ulcerative colitis for 8 years or more. Bowel biopsies are painless (other than the potential discomfort of the scope procedure) and remove only a tiny piece of tissue.

Some people have symptoms of inflammatory bowel disease and neither Crohn's disease nor ulcerative colitis can be diagnosed. These people have a form of inflammatory bowel disease called indeterminate colitis, which doctors believe is a combination of Crohn's disease and ulcerative colitis.

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