Types of Procedures for IBD

Read to learn about common procedures/tests for IBD, how they work, and how they impact the lifestyle of IBD patients

Endoscopies and colonoscopies are two common diagnostic tools that are used to see if someone has UC and Crohn’s and how far the disease has or has not progressed
Specific Terms:
Upper endoscopy: This is when a flexible tube is inserted through the mouth to view the esophagus, stomach, and small intestines.
Colonoscopy: This is when a flexible tube is inserted through the rectum to view the large intestine, colon and rectum.
Purpose: Colonoscopies and endoscopies are routine tests for IBD patients, and must be done on a regular basis to monitor disease progression and to screen for colon cancer
Impact on Lifestyle: Patients in remission usually need to get scopes done every two years, but it can be more frequently based on: flares, medication changes, or other times when your doctors need the information
Scopes interrupts daily life, because preparation for the procedure and recovery can range from hours to days
It is important for patients to consider how a procedure will interrupt their lifestyle so they can plan accordingly

Scopes

Imaging

Imaging procedures are non-invasive diagnostic methods to check how a patient is doing:

MRI/MRE scans, CT scans, X-rays, Ultrasounds
Purposes: locate inflammation, strictures, and general issues in the GI tract
Process: Patients may need to drink contrast solution before the imaging, which is looked at by a radiologist and discussed afterwards with the patient's GI
Impact on Lifestyle: These tests do not require a significant interruption to your lifestyle, because the preparation and procedure are usually done all on the same day. They are also not done on a routine basis, and are instead usually done when your doctor wants to get more information about your disease.

Blood Tests

Common blood tests for IBD: sedimentation rate, C-reactive protein, Complete Blood Count, Comprehensive Metabolic Panel, Ferritin, Iron, Leukocyte Scintigraphy (white blood cell scan), Vitamin D, electrolytes, and antibody tests.
**None of these are enough to diagnose IBD on their own but they are helpful for diagnosis and monitoring disease activity
Some blood tests are routine, while others may be done in response to flares
Purpose: Inflammation markers (sedimentation rate, C-reactive protein test) show much inflammation is happening in your body. Other tests can check vitamin levels. Antibody tests can see if your blood is developing resistance to certain medications
Impact on Lifestyle: Routine blood tests require planning and regular communication with your doctor
One IBD patient says, “I wish [other people] knew how often I get blood work or stool work done and how tiring it is to constantly be thinking about having an illness”.

Stool Test (Fecal Calprotectin)

This test is used to help identify the cause of a patient's symptoms. A stool test can be used to check if there is an infection that is causing your symptoms rather than your IBD. This can also be used to detect an increase in calprotectin protein which can indicate an active flare. Stool tests are often scheduled along with other routine tests such as blood tests, which can be convenient because you can do all of the tests at once. These tests are also often more accurate and specific to GI inflammation and they can test for C.Diff and similar stool based diseases and infections.

Bone Density Scans

Some IBD patients may need to have bone density scans to see if their bones have lost density due to medication side effects or IBD. These scans are similar to MRI scans or X-rays but tell you whether your bones are healthy. These also do not cause a significant lifestyle interruption because they do not usually require preparation, though they do take longer than a normal doctor’s appointment.

Capsule Endoscopy

A non-invasive test that achieves the same results as a full endoscopy and colonoscopy, but it is done by a small capsule the size of a pill that then takes pictures while inside the GI tract wirelessly. Capsule endoscopies are more convenient and helpful for a patient with IBD since it allows people more agency (i.e. they do not have to physically come in for a procedure).

Feeding Tube Placement

Feeding tubes are a way of providing your body with enteral nutrition, which is a nutrient-rich formula that can help your body heal without eating solid food. This uses nasogastric or nasojejunal tubes, which go through your nostril to your stomach or nostril to small intestine, respectively. When you have a feeding tube, you may be able to eat normal food (PEN) or you may be required to exclusively use the formula (EEN). These tubes are changed and can be taken out in the morning and replaced at night or worn all day. Either option can affect your lifestyle significantly because it changes diet, are visible, and may interfere with social activities. When the feeding tube is first placed, patients may seek assistance by a clinic or hospital and may stay over night for monitoring. After this initial placement, patients and families are taught to place the tub on their own.