Diagnosing Ulcerative Colitis
How does the doctor know that it's ulcerative colitis?
Your doctor needs information from you to accurately diagnose ulcerative colitis (UC). Diagnosing UC begins with you and your doctor having a detailed discussion about your health (called a patient history). It's important to share details about your symptoms, recent travel, and medication use (to rule out infections, parasites, or drug allergies). Your doctor will also need to know if there is a family history of digestive disorders, including inflammatory bowel disease (IBD). After a thorough physical exam, blood tests, and a stool sample, your doctor may order other tests as well to confirm the diagnosis.
Do I have inflammatory bowel disease (IBD) or irritable bowel syndrome (IBS)?
IBD and IBS are 2 very different intestinal disorders. However, they are sometimes confused because they not only sound alike but also share similar symptoms, like diarrhea, cramping, and bloating. To understand the difference between the 2 conditions and to make sure you're getting what you need from your treatment, just ask.
How are IBD and IBS different? IBD is short for "inflammatory bowel disease," and is linked to inflammation and ulcers in the bowel. Ulcerative colitis and Crohn's disease are types of IBD. IBS is short for "irritable bowel syndrome," and is considered a "functional" disorder that gets in the way of how the intestines function.
Are the symptoms of IBS different from those of IBD? A person with IBS can experience abdominal pain, but more commonly has a continually changing bowel pattern, fluctuating between diarrhea and constipation. IBS does not produce inflammation or the cellular damage caused by inflammation, so it is not considered a disease. Another difference is that IBS does not produce ulcers, anemia, bleeding, weight loss, or fever—all of which may occur in IBD.
How can I tell which disorder I have? If you're not sure whether your symptoms match up with IBD or IBS, just ask your doctor. It's also a good idea to keep track of your symptoms to help your doctor make an accurate diagnosis.
What's the difference between ulcerative colitis and Crohn's disease?
Ulcerative colitis and Crohn's disease are both types of IBD. The symptoms of UC are similar to those of Crohn's disease. The two are so similar that 10% of people with UC are diagnosed with "indeterminate colitis" because test results don't clearly point to one or the other. However, there are a few traits of each condition that can help doctors make the right diagnosis.
What are the key traits of UC? Ulcerative colitis is limited to the colon, also known as the large intestine. It affects only the inside layers of the colon (called the "mucosa" or "lining"). Inflammation and ulcers start at the rectum and progress up through the colon in a continuous pattern, without skipping over any part of the colon.
How are the traits of Crohn's disease different? With Crohn's disease, the entire gastrointestinal (GI) tract is susceptible to disease, including the colon, the small intestine, the stomach, and even the mouth. All layers of these organs may be involved—not just the inside layer. Crohn's disease can also appear in patches throughout the GI tract, skipping over healthy sections of intestine.
What are the specific tests for ulcerative colitis?
There are multiple tests used to diagnose ulcerative colitis. In addition to the physical exam, you may be asked to get a blood test to check for anemia, which may occur when there is bleeding in the colon. Other tests, including a sigmoidoscopy or a colonoscopy, may be performed as well.
What is a sigmoidoscopy or colonoscopy? If your doctor suspects UC, he or she may order one of these tests to determine how severe your condition is. These tests may also be used later on to find out whether or not your condition has become worse. Both are outpatient procedures conducted by a specialist.
A sigmoidoscopy uses a flexible scope to directly examine the rectum or lower colon. The scope transmits a video image from inside the lower colon onto a computer screen so the doctor can examine the tissue lining.
A colonoscopy examines the entire colon and also transmits video of the colon tissue. This procedure can last 30 to 60 minutes. If your doctor orders a colonoscopy, it is very important that you follow the prep instructions very carefully and thoroughly, so the doctor is able to see the colon lining clearly.
