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Diagnostic Evaluation for IBD

April 27th, 2011

Inflammatory bowel disease (IBD) is an umbrella term used to describe a group of inflammatory disorders of the gastrointestinal tract. Each of these disorders involves some degree of inflammation (redness, swelling, erosion and sometimes bleeding) of the gastrointestinal mucosa or lining that commonly leads to ulceration of the mucosa to varying degrees. The inflammation is usually a result of an immune reaction of the body against its own intestinal tissue. Therefore, the diseases included in IBD are considered to be autoimmune disorders.

Diagnostic Evaluation for IBD

This is Part 2 of a 5-part article including:

1. An Integrated Approach to Managing Inflammatory Bowel Disease

2. Diagnostic Evaluation of IBD

3. IBD Treatment: Remove the Obstacles to Cure

4. IBD Treatment: Quiet the Inflammation

5. IBD Treatment: Repair the Gut

(or, download the PDF of the entire article)

Inflammatory bowel disease (IBD) is an umbrella term used to describe a group of inflammatory disorders of the gastrointestinal tract. Each of these disorders involves some degree of inflammation (redness, swelling, erosion and sometimes bleeding) of the gastrointestinal mucosa or lining that commonly leads to ulceration of the mucosa to varying degrees.Blood work must be done and should include complete blood count, blood chemistry, iron studies, nutrient evaluation, and inflammatory markers. In agreement with the latest scientific research, I highly recommend screening for celiac disease. This includes genetic testing and blood tests for immune reactions as well as intestinal biopsies. It is important to note here according to the latest research, biopsies can be negative in patients with latent celiac disease. Celiac screening is especially important with microscopic colitis. A blood test called IBD serology (pANCA and pASCA) may be done if there are questions over the biopsy results regarding diagnosis of ulcerative colitis versus Crohn’s disease.

Stool samples should be examined to rule out infectious (bacterial or parasitic) causes of symptoms. This may include Complete Stool Diagnostic Analysis (CSDA) which checks for multiple stool factors to determine quality of digestion, absorption, bacterial environment, parasites, blood, inflammation, etc.

Nutritional evaluation should be done, especially with Crohn’s disease. This should include evaluation of electrolytes, zinc, folic acid, iron, B12, vitamin D25, total protein, albumin, and others. I highly recommend being tested for food allergies and intolerances such as celiac disease and lactose intolerance. This nutritional evaluation can include blood tests (IgE RAST and IgG4 RAST) or skin scratch testing to identify allergic foods.

Diagnostic Procedures will definitely include a colonoscopy and biopsy as this is the “Gold Standard” for diagnosing IBD. Sometimes a CT scan will be done to check for strictures, abdominal abscesses, fistulas, or obstruction of the intestines when the symptoms indicate it. Plain X-Rays of the abdomen could be done as a quick, easy, and inexpensive way to show narrowing of the intestines or an intestinal blockage. Contrast X-Rays such as barium swallow (small intestine) and barium enema (large intestine) might be done as well.

This is Part 2 of a 5-part article including:

1. An Integrated Approach to Managing Inflammatory Bowel Disease

2. Diagnostic Evaluation of IBD

3. IBD Treatment: Remove the Obstacles to Cure

4. IBD Treatment: Quiet the Inflammation

5. IBD Treatment: Repair the Gut

(or, download the PDF of the entire article)

References

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About the Writer

Dr. Patrick Donovan of TheDispensaryOnline.comDr. Donovan is a Naturopathic Physician, author, educator, and a professor of clinical medicine at Bastyr University's Natural Health Clinic. In 2010 he was voted by his professional peers as one of Seattle’s Top Doctors in the Seattle Metropolitan Magazine. Dr. Donovan writes and lectures on the transformational process of healing and believes a person’s healing journey is ultimately a quest for his/her identity, purpose and meaning. He has more than 35 years of patient care experience as a Registered Nurse (RN) and a Naturopathic Physician (ND), representing a wide range of clinical settings from hospital-based surgical and intensive care as a registered nurse to outpatient primary care as a physician.

Copyright 2011. The contents of this article may be reused, but must be reused in full (and full credit given to its authors). If you have specific questions, please contact us.

April 27th, 2011 by Dr. Patrick Donovan


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