If you’ve been struggling with frustrating gut issues like persistent stomach pain, bloating, diarrhea or even blood in your stool, you’ve likely wondered if you may have inflammatory bowel disease (IBD). It can be a long, confusing and overwhelming process to determine the cause of your gut symptoms. So we’ve put together a comprehensive guide of everything you’ll need to know about the diagnosis process if you suspect you’re suffering with IBD symptoms from Crohn's disease or ulcerative colitis. Getting an accurate diagnosis is the first step towards finding an effective treatment plan and relief so keep reading for all of the likely steps, tests and doctors involved in getting an IBD diagnosis.
What is IBD? Understanding Crohn’s Disease and Ulcerative Colitis
Inflammatory bowel disease (IBD) refers to chronic inflammation in your digestive tract. The two most common forms of IBD are Crohn’s disease and ulcerative colitis. While both cause inflammation, they affect different parts of the digestive system. (Confused on the differences between IBS and IBD? Check out this blog post.) IBD symptoms can range from mild to debilitating and may include:
- Persistent diarrhea
- Abdominal pain and cramping
- Blood in stool
- Fatigue
- Unexplained weight loss
When to See a Doctor for IBD Symptoms
Your journey towards getting an IBD diagnosis will likely start with a visit to your primary care doctor to talk about your symptoms and concerns. Your primary care doctor may run some bloodwork and can refer you to a gastroenterologist — a doctor specializing in digestive system disorders. If you’re experiencing severe or ongoing gut issues, it’s essential to see a specialist as soon as possible. A gastroenterologist specializes in assessing symptoms and can recommend the right tests needed in order to get an IBD diagnosis.
Signs It’s Time to See a Doctor for Your Gastro Symptoms:
- You’ve had symptoms for more than a few weeks.
- Your symptoms are interfering with your daily life.
- You notice blood in your stool.
- You’re experiencing unexplained weight loss or fatigue.
Tests Needed Before Getting an IBD Diagnosis: Bloodwork, Stool Samples and More
In order to get an IBD diagnosis, your doctors will order a combination of various tests to first rule out other potential causes for your symptoms like infections or irritable bowel syndrome (IBS). Here are some of the key tests a gastroenterologist may recommend in order to properly determine an IBD diagnosis:
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Which Blood Tests Can Detect IBD?
Blood work is typically the first step many doctors will order as blood tests can help identify inflammation levels and help rule out infections or anemia, which can be associated with IBD.
Inflammation Markers: Blood tests for C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) can indicate inflammation in the body.
Anemia Screening: IBD can lead to blood loss in the stool, causing anemia. A complete blood count (CBC) test can detect this.
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Stool Testing for Inflammatory Bowel Disease
One of the next tests a doctor may order after getting blood work done are stool tests. These are crucial in helping your gastroenterologist rule out infections and detect inflammation in your digestive tract.
Fecal Calprotectin Test: This test looks for a specific protein in the stool that indicates your intestines have inflammation which is common for IBD patients.
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Endoscopy and Colonoscopy Testing for an IBD Diagnosis
Based on your blood work and Fecal Calprotectin tests, your doctor may recommend an endoscopy and/or colonoscopy to visually see what’s going on in your digestive system. These procedures use a thin, flexible tube with a camera to examine the intestines and take biopsies if needed.
Endoscopy: Focuses on the upper digestive tract including the esophagus, stomach and duodenum.
Colonoscopy: Allows your doctor to examine the colon and rectum for signs of inflammation, ulcers or bleeding.
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Imaging Tests for an IBD Diagnosis
And finally in some cases, your doctors may even order imaging tests like CT scans or MRIs to get a detailed look at the intestines. These tests are more likely to be ordered if Crohn’s disease is suspected, as it can affect deeper layers of your bowel.
The Role of Microbiome Testing in Diagnosing IBD
At-home microbiome testing has recently gained popularity as an additional tool to help people better understand what’s going on with their gut health. While microbiome testing cannot be used to diagnose IBD, testing your gut health can provide you with valuable insights into your gut flora (the balance of good and bad bacteria in your digestive system), identify imbalances and highlight inflammation in your digestive system.
- Gut Microbiome Analysis: Microbiome testing like Injoy’s 3-Sample Microbiome Test analyzes the diversity and levels of bacteria in your gut. Studies suggest IBD patients often have lower microbial diversity and higher levels of harmful bacteria, so learning about your unique gut can be a helpful first step. Injoy also compares your samples to those diagnosed with IBD, showing if you have similar inflammation to IBD patients or bacteria commonly linked to IBD. Once you receive your results, you can discuss them with your primary care doctor or gastroenterologist for further guidance.
“Injoy let me know my gut health was clearly suffering and that my microbiome was similar to patients with IBD. Because I had this information, I was confident enough to ask my GI for a colonoscopy and was diagnosed with Crohn’s Disease!” -Linnea, Injoy customer
Which Doctors or Specialists Should You See for an IBD Diagnosis?
While a gastroenterologist will lead the process towards getting an IBD diagnosis, there are other specialists you might need to (or want to) consult with:
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Should You See a Dietitian or Nutritionist for IBD?
IBD can affect nutrient absorption and diet can play a critical role in helping IBD patients to manage symptoms. A dietitian or nutritionist can help you create an IBD-friendly diet plan to help reduce flare-ups and ensure you’re getting the essential nutrients you need.
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When to Consult an Immunologist or Rheumatologist for IBD
Because IBD is an autoimmune disorder, your immune system plays a central role in disease progression and an immunologist may be needed to help assess the underlying autoimmune factors contributing to your IBD symptoms.
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Do You Need a Colorectal Surgeon for IBD Treatment?
If your IBD is severe, in advanced stages or is not responding to medication, you may need to see a colorectal surgeon. Surgery is typically a last resort but can be necessary and extremely beneficial for IBD patients with severe cases.
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Why Seeing a Therapist Can Be Helpful in Managing IBD
Being diagnosed with IBD can be overwhelming as living with a chronic illness doesn’t only affect your body but also your mental health. Stress, anxiety and depression are common in those living with chronic conditions like IBD AND and they can often make your IBD symptoms worse. A therapist familiar with IBD or chronic illnesses can help you develop coping strategies, better manage stress and provide you with emotional support.
How to Prepare for Your Appointment to Get an IBD Diagnosis
The road to getting answers and an IBD diagnosis can feel like a long, lonely and overwhelming journey so it’s not unusual if you’re feeling a little nervous about upcoming appointments. Before your appointments, it’s helpful to gather some important information to bring and discuss with your doctor:
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Track Your Symptoms: Keeping a symptom diary can help your doctor really understand what symptoms you’re experiencing, the frequency and how your symptoms have progressed over time. An app like Injoy helps simplify this process by allowing you to track your daily symptoms, food intake, bowel habits and so much more all in one place. With consistent tracking the Injoy app can even help identify potential food triggers, track patterns and monitor the severity/frequency of your symptoms. Having this detailed information ready to share with your doctor can help lead to a more accurate diagnosis and personalized treatment plan.
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Bring a List of Questions: Preparing a list of questions can help you feel more confident in navigating the appointment and IBD diagnosis process. Not sure where to start? Try a tool like GutChat, Injoy's AI-powered tool built with an extensive database of peer-reviewed research, to create a tailored list of questions to ask at your appointment. GutChat can instantly provide insights into what you should ask about, more info on the types of tests recommended for diagnosing IBD, the potential benefits of microbiome testing and treatment options. Having a well-prepared list of questions before your appointment will help you better understand the IBD diagnosis process, potential treatment options and feel more confident trusting your "gut feelings".
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Bring Your Microbiome Test Results: If you’ve already taken a microbiome test, be sure to bring your report with you to your appointment! The Injoy report will include details about your gut health score, inflammation levels and other relevant findings. This information can then give your doctor additional insights into your gut's bacterial balance.
- Review Your Family History: Lastly, IBD can run in families so it is extremely important to know your family’s medical history as this can provide your gastroenterologist with useful context needed to getting an IBD diagnosis.
Final Thoughts on Getting an IBD Diagnosis
Finally receiving an IBD diagnosis can be a life-changing moment with mixed emotions. You may first feel a wave of relief to finally have answers for your frustrating gastro symptoms followed by a wave of grief or sadness that you’ll now be navigating life with a chronic illness.
Allow yourself to feel all of the feelings associated with getting an IBD diagnosis and just know that you are not alone on this journey! This diagnosis also opens the door to finding an effective treatment plan and finally improving your quality of life.
If you’re curious about your gut health or suspect you’re suffering from IBD, consider looking into microbiome testing to get some initial insights into your current gut health status. While at-home microbiome testing won’t replace the blood work or stool tests needed for an IBD diagnosis, it can offer valuable insights that may help both you and your doctor create a more personalized treatment plan.
