How Doctors Diagnose Crohn's Disease

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Doctor testing Woman's Stomach

Crohn’s disease is the chronic inflammation of the body’s gastrointestinal (GI) tract. Because the symptoms of Crohn’s—including ongoing diarrhea, abdominal pain, constipation fever—can occur with many other conditions, it can take time to get a definitive diagnosis. 

But if you’re experiencing Crohn’s symptoms, it’s essential to talk to your doctor since a prompt and accurate diagnosis can help you start effective treatment as soon as possible.

Crohn’s Disease Symptoms

Since Crohn’s symptoms are common, it’s important to work with a physician who can give you the proper tests to rule out other health issues and get a correct diagnosis. Symptoms of Crohn’s can vary from person to person, and can include:

  • Ongoing diarrhea

  • Rectal bleeding

  • Persistent feeling of needing to move the bowels

  • Abdominal pain

  • Feeling like the bowels can’t fully empty

  • Constipation

  • Fever

  • Not feeling hungry/weight loss

  • Feeling tired/low energy

  • Night sweating

  • Disappearance of a woman’s periods

In advanced or untreated cases, Crohn’s can cause anal fissures (skin tears that can cause pain and bleeding) or fistulas (abnormal tissue connections between the intestine and the bladder, vagina, or skin). These are medical emergencies and require immediate care.

How Crohn’s Is Diagnosed

No one test will diagnose Crohn’s. Your doctor will give you a full physical exam and focus closely on your abdomen, looking for swelling and pain, and listening to how it sounds. You’ll also be asked about your medical history and what medications you are currently taking or have taken in the past. You’ll also be examined to see if your spleen or liver are larger than normal.

You’ll also likely have one or more tests to help determine whether you have Crohn’s. These can include:

  • Lab tests, such as a blood test, to analyze whether you have an abnormal number of red or white blood cells, which can indicate anemia (causing fatigue) or inflammation (a sign of infection). You may also need to give a stool sample for testing, which might show other digestion problems.

  • Imaging tests, such as X-rays or CT scans, to provide doctors with a visual picture of the internal GI tract. For an upper GI series of X-rays, you’ll drink barium, a chalky liquid that makes it easier to see the upper GI tract in an image. A radiologist and X-ray technician will then observe how the liquid moves through your body. CT scans use computer technology, plus an injected dye called contrast medium, to produce a digital image.

  • Outpatient diagnostic procedures, which often take place in a doctor’s office and don’t require an overnight hospital stay. For a colonoscopy, your doctor examines your rectum, colon and lower small intestine with a small camera inserted through the anus. An upper GI endoscopy uses a camera inserted down the throat to look at the esophagus, stomach and duodenum. An enteroscopy test looks at those areas, plus the small intestine. In a capsule endoscopy, you swallow a small camera that shows images of the working GI tract as the camera moves through. You excrete the camera into the toilet with a bowel movement and flush it away. In these tests, doctors may also take a small piece of tissue from the GI tract for a biopsy, to examine for any changes or evidence of disease. For all these procedures, you are given numbing medication to avoid discomfort, as well as specific instructions on how to keep the GI tract free of food and fecal waste so the scan is as clear as possible.

Once you have received a definitive diagnosis of Crohn’s disease, you’ll learn about different medications, dietary recommendations, and potential surgeries that can help you treat and control your condition. Working with your healthcare provider, it’s possible to live a full and healthy life with Crohn’s disease.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Sep 23
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

  1. Definition and Facts for Crohn’s Disease. National Institute of Diabetes and Digestive and Kidney Diseases.

  2. What are Crohn’s and Colitis? Crohn’s & Colitis Foundation of America.

  3. Crohn’s Diagnosis and Testing. Crohn’s & Colitis Foundation of America.