How can I tell if I have ulcerative colitis?
Frequent, painful diarrhea is the symptom that sends most people who have ulcerative colitis to a doctor to find out what's wrong. In addition to diarrhea, it's important to tell your doctor any other symptoms that you have. Ulcerative colitis can be difficult to diagnose, so your doctor will perform a thorough examination to find out if you have the disease. Here are some things your doctor may do:
First, your doctor will take a personal medical history and ask you many questions about illnesses and diseases that you have had in the past, as well as other facts about your own and your family's medical histories.
You will also receive a thorough physical examination and be asked to provide a stool (bowel movement) sample. This will be looked at through a microscope to make sure your diarrhea is not being caused by a virus, bacterium, or parasite.
Your doctor also will take a sample of your blood so it can be tested in a laboratory. This test will reveal any signs of infection or a low red blood cell count (anemia), which is one result of bleeding in the colon or rectum.
In addition to a medical history, physical exam, and blood test, what other procedures will my doctor perform?
Sigmoidoscopy (pronounced "sig-moi-dos-kuh-pee"), Colonoscopy (pronounced "koh-luh-nos-kuh-pee")
Your doctor also will want to evaluate the condition of your colon through an internal exam called a sigmoidoscopy or colonoscopy. This exam can determine the part of your colon that is inflamed. The sigmoidoscopy allows your doctor to examine the lower portion of the colon, and a colonoscopy allows your doctor to examine the entire colon.
During either exam, a long, very thin, flexible, lighted tube (endoscope) is inserted through the anus, past the rectum, and into the colon. At the end of the tube is a tiny camera that is connected to a computer and TV monitor, so the doctor can see any inflammation, bleeding, or ulcers on the colon wall. During the colonoscopy or sigmoidoscopy, your doctor may take a small amount of tissue from the lining of the colon to examine under a microscope for cancer cells and other possible problems. That examination of the tissue is called biopsy.
Barium enema
Sometimes a barium enema x-ray is used to identify ulcerative colitis. To take this kind of x-ray, your doctor will insert liquid through a small tube into your anus, past your rectum, and into your colon. The liquid contains a chalky white solution, called barium. The barium will make certain abnormalities in your colon appear as dark spots or patterns on the x-ray.
If the diagnosis is ulcerative colitis, in most cases you will need additional tests from time to time to keep track of how the disease is doing, identify complications, or evaluate the side effects of medications.
Next: How is ulcerative colitis treated?