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Crohn's disease is one of the toughest gastrointestinal (GI)diseases for healthcare providers to diagnose. The reason for this is because it is like a Trojan horse, hiding away while mimicking so many other GI conditions. So of course it is often tough to tell exactly what you are dealing with... mimics others and yet can still manage to make your life miserable! Crohn's disease symptoms run the gamut from mild to quite debilitating and these symptoms can vary wildly from individual to individual. This is just another challenge to getting an accurate and timely diagnosis. Another bee in the "tough to diagnose" bonnet is the fact that there are no definitive and firm guidelines that absolutely identify Crohn's disease. Not a fair break! Currently there isn't one absolute test that your physician can elect to use to definitely diagnose your Crohn's disease, it is simply a matter of taking the time to eliminate other GI diagnosis while trying to correctly identify what in the world is going on in your gut. Kind of like trying to master a 10,000 piece puzzle. As your physician tries to determine if you do have Crohn's or not, one of the easiest medical exams to help on the journey is a stool sample. This sample can help your doctor to determine if your bowel upset is caused by an infection or by inflammation. In the case of Crohn's disease, inflammation of the G.I. tract presents itself as if there is an infection but there is no infection present. So you can see by obtaining a simple stool sample several possibilities can easily be ruled out. Well, once your physician has had a good look at your poop and has had a chance to see if it is infection or inflammation hiding within, the next thing on the "tests" to do is typically several other standardized tests. Some of those tests may include drawing blood to assess your complete blood count to check for signs of anemia due to blood loss and for signs of infection, a CT scan of your belly, or even a colonoscopy, a flexible sigmoidoscopy and perhaps a barium enema. Some physicians may also elect to have you get a small bowel x-ray series and even a capsule endoscopy. Once your test results come back, your health care provider will review them thoroughly before discussing them with you. One of the key things to remember is that if your additional blood work indicates that an infection is present then it is less likely that you have Crohn's disease. However, if your blood work shows that anemia is present, then Crohn's disease is more of a possibility. So you should already be able to see how difficult diagnosing Crohn's disease can be. However, just like putting the pieces of a puzzle together your physician should keep on going until a definitive diagnosis is made. You are worth it. Other symptoms of Crohn's may include bloody diarrhea and even rectal bleeding. Here's where the CBC can tell the real story. With excessive blood loss your blood work may show signs of anemia. So detective doc, just got one more piece of the mystery fitting into place. If your lab work shows indications of anemia, then when combined with your other symptoms it is quite possible that a diagnosis of Crohn's disease is in your future. A colonoscopy may be helpful in getting to the bottom of your symptoms. Generally performed by a gastroenterologist, a colonoscopy can only be performed after you have completed a rigorous bowel prep so that your colon is thoroughly clean out. If there is still stool in the colon then your physician cannot see your colon. Make sense? So once you've completed the bowel prep, after mild sedation your physician will insert a flexible lighted tube that has a tiny camera attached to it through your rectum and into your colon. With the lighted tube and tiny camera your physician can see the colon and can assess for the presence of Crohn's disease. It is important to remember with any medical procedure and there are risks associated with it. Risk associated with a colonoscopy include G.I. bleeding and perforation of the colon wall. There are a few downfalls with a colonoscopy, though. It is not a perfect test. Remember that Crohn's disease may only be found in the small intestine and so if that is your story then a colonoscopy simply won't do you any good. So a colonoscopy may or may be the sure fire hit to tell you if you have Crohn's and so your doc may decide to instead order a flexible sigmoidoscopy. While it is pretty similar to the colonoscopy, the one major change is that this little tube does not contain a camera. With this exam your physician would use the lighted tube to look at the inside of the last 2 feet of the colon to see if there are any signs of Crohn's disease. If your physician sees evidence of Crohn's in those last two feet of the colon, then a definitive diagnosis could be made. As with all tests, even the flexible sigmoidoscopy has some downfalls. The bad news is that Crohn's disease can hide higher up in the colon and so if that is the case, the the flexible sigmoidoscopy would be totally useless. Well, it should be rather clear by now that if you have any symptoms of Crohn's disease that it may take while for your healthcare provider to put all the pieces of the puzzle together and to get to an accurate diagnosis. This is not something that can taken lightly and it is important that an accurate diagnosis is reached before rushing to judgment just to have an answer on the table. Because it mimics so many other diseases diagnosing Crohn's disease can be a challenge. However, it is a challenge that is certainly worth undertaking so that you can get back to being a healthy you.
By: Tammy Foster
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