Imaging Tests to Diagnose & Monitor IBD

Editor’s note: For World IBD Day 2019, community members submitted questions for Dr. Nandi. This video was recorded by Dr. Nandi on World IBD Day and was published at a later date.

One of the Community's questions "What kind of imaging tests can we do to look inside the bowel, short of a colonoscopy?"

Imaging tests may include CAT scans or MRI. These aren't utilized much for Ulcerative Colitis unless the doctor is looking to rule out an alternate diagnosis of Crohn's disease. Whereas UC only affects the large intestine (colon), Crohn's disease may additionally affect the small intestine as well which can be imaged well by an MRI or CAT scan. Indeed, MRI is the preference because it avoids radiation. Strictures or thickening in the small intestine may suggest inflammation. Imaging tests can also identify pelvic fistulas or abscesses.

Another way to evaluate the small intestine is with a capsule endoscopy which is a video camera in a pill. The capsule does not require sedation and can record up to 8 hours of footage. One risk your physician can weigh for you is the risk of a capsule getting stuck at a stricture which is known as an obstruction. Fortunately there are ways to determine whether you have a stricture in advance of the capsule.

Ultrasound is a newer and less commonly used test for inflammatory bowel disease, but it is hopeful that this will become more widely used for immediate answers.

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