IBD Diagnosis and Evaluation

Abstract

The diagnosis and evaluation of ulcerative colitis and Crohn’s disease is critically important to provide appropriate patient care. Familiarity with modes of clinical presentation allows the clinician to promptly select the most efficient combination of tests. Knowledge of histologic findings of ulcerative colitis and Crohn’s disease facilitates discussion with other physicians of the care team and tailors specific medical and surgical therapies. Serologic tests such as ASCA, pANCA, and fecal markers such as calprotectin are increasingly becoming utilized for diagnosis and treatment effectiveness monitoring. Technologic advances in endoscopy are dramatically altering the usefulness of these already critically valuable tools. High definition images, chromoendoscopy, confocal laser endomicroscopy, and double balloon enteroscopy add to the ability to diagnose and treat. Similar advances in radiology are revolutionizing the care of the IBD patient as capsule endoscopy, computerized tomography and computerized tomography enterography, magnetic resonance imaging, and magnetic resonance enterography provide previously unimagined ability to visualize disease.