Diagnosing Crohn’s
Getting diagnosed with Crohn’s can take time. That’s because the symptoms can be similar to other conditions and there’s no single medical test for it. Crohn’s is usually progressive, which means it’s likely to get worse over time for some people.
Getting diagnosed with Crohn’s
Your healthcare provider will likely perform a physical exam, ask about your family medical history, and use a combination of testing methods to make a diagnosis. It may include lab tests of your blood and stool. Imaging and endoscopic procedures also provide important information.
Some of these tests and procedures may also be performed throughout your journey with Crohn’s to assess disease activity and how you may or may not be responding to therapy.
Blood tests
A type of protein that can be found in the blood. If there are higher levels of this protein, it means there is inflammation occurring in the body.
This test is used to find out if there is inflammation in the body based on how quickly red blood cells settle in a test tube.
This test measures your red and white blood cells, as well as hematocrit, hemoglobin, and platelets.
Imaging tests
An X-ray of your abdomen can help assess different issues in your digestive system.
A CT scan uses X-rays along with a computer to create detailed images of your gut and surrounding areas.
An MRI uses a magnetic field and radio waves to create images of your gut and surrounding areas without any exposure to radiation.
An ultrasound uses sound waves to create images of structures inside the body.
Endoscopic procedures and biopsy
A biopsy is a procedure that collects a tissue sample that is later examined under a microscope. A tissue sample can be taken from your digestive tract during an endoscopic procedure.
This procedure gives an inside look of your entire colon using a tiny tube that has a camera on the end.
This procedure uses a tiny tube that has a camera on the end to examine the upper part of your digestive tract, including your esophagus, stomach, and the beginning of your small intestine.
This procedure helps find problem areas in your small intestine. For this procedure, you swallow a capsule that has a camera in it that scans your digestive tract as it makes its way through the tract and exits your body in your stool.
This procedure uses a long thin tube with a balloon and a camera at the tip to examine your small intestine.
Stool tests
Fecal calprotectin levels can be used as a marker to detect inflammation in the intestine.
Severity and progression
There is no single test to assess and monitor Crohn’s progression. Different clinical measures, how your symptoms impact your life, along with complications of the disease and of therapy will factor into how your healthcare provider makes an assessment related to your disease severity and progression.
Chronic intestinal inflammation can lead to complications, like strictures and fistulas. Strictures occur when scar tissue builds in a section of the intestine, narrowing the passage. Fistulas are an abnormal connection between an organ and another structure caused by deep sores or ulcers in the intestinal tract. There are other things that help care teams determine the severity of your Crohn’s. That information can typically be found by using a combination of testing and imaging.
See the table below for more information on the levels of severity.
| Weight loss | No |
| Eating/drinking | Normal |
| Fever | No |
| Abdominal mass | No |
| Diarrhea | No |
| Abdominal pain/tenderness | No |
| Symptoms | Without any symptoms |
| Weight loss | <10% |
| Eating/drinking | Normal |
| Fever | No |
| Abdominal mass | No |
| Diarrhea | Possible |
| Abdominal pain/tenderness | Possible |
| Symptoms | Symptoms, but with minimal impact on daily living |
| Weight loss | Significant |
| Eating/drinking | Impaired |
| Fever | Yes |
| Abdominal mass | Yes |
| Diarrhea | Possible |
| Abdominal pain/tenderness | Yes |
| Symptoms | Symptoms persist despite treatment |
| Weight loss | Significant; muscle wasting |
| Eating/drinking | Impaired |
| Fever | Yes |
| Abdominal mass | Yes |
| Diarrhea | Yes |
| Abdominal pain/tenderness | Yes |
| Symptoms | Symptoms persist despite aggressive treatment; abscess and persistent vomiting possible |
| Weight loss | Eating/drinking | Fever | Abdominal mass | Diarrhea | Abdominal pain/tenderness | Symptoms | |
| Remission | No | Normal | No | No | No | No | Without any symptoms |
| Mild | <10% | Normal | No | No | Possible | Possible | Symptoms, but with minimal impact on daily living |
| Moderate-severe | Significant | Impaired | Yes | Yes | Possible | Yes | Symptoms persist despite treatment |
| Severe-fulminant | Significant; muscle wasting | Impaired | Yes | Yes | Yes | Yes | Symptoms persist despite aggressive treatment; abscess and persistent vomiting possible |
Seeking care
The following may be symptoms of a flare-up, and you should seek care if you’re experiencing any of them.
Abdominal pain (or stomach pain or cramping)
Blood in stool
Nausea and vomiting
Losing weight without trying
Diarrhea or changes in bowel movements
Fever in combination with any of these symptoms
Is there a specialist for Crohn’s?
Often, a gastroenterologist—a doctor specializing in the digestive system—oversees Crohn’s care.
Your IBD care team
A multidisciplinary inflammatory bowel disease (IBD) care team typically includes healthcare professionals from different specialties. The goal is to offer all-encompassing care to support the physical, mental, and emotional impacts of the disease.
Your team may include a gastroenterologist, primary care physician (PCP), internist, pharmacist, specialists for extraintestinal issues, psychologist, dietitian or nutritionist, nurse or nurse navigator, or colorectal surgeon.
Prepare for your next appointment
Talking with your care team about your symptoms can be scary. Being prepared can help. Before your next appointment, consider doing the following:
- Jot down exactly what’s going on with your body and any concerns you have
- Ask a friend/family member to come with you
- Trust yourself and be your own advocate
We can help you get started with a personalized discussion guide that's tailored to you—and your gut.
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