As part of our occasional series on endoscopy treatments, we focus on Crohn’s disease and Ulcerative Colitis – conditions that can be diagnosed though an endoscopy - a service that is available at our hospital.
What is Crohn’s Disease or Colitis?
Crohn’s Disease and Ulcerative Colitis are Inflammatory Bowel Diseases (IBDs).
- In the UK, about 1 in 210 people (around 300,000) have Crohn’s or Ulcerative Colitis
- Crohn’s Disease and Ulcerative Colitis can start at any age, but they usually start before 30 years of age
- Everyone is different: some people with Crohn’s or Ulcerative Colitis feel well most of the time, other people take longer to find a treatment that’s right for them
- Not everyone feels the same, and how you feel can change over time
What are the symptoms of Crohn’s Disease or Ulcerative Colitis?
Crohn's disease symptoms include diarrhoea, tiredness, weight loss and abdominal cramps but there are others such as swollen joints, mouth ulcers and inflamed eyes. Ulcerative colitis starts with increasing diarrhoea with urgency, low abdominal cramps and bleeding from the back passage.
Crohn’s and Ulcerative Colitis are chronic, relapsing conditions which means that you’ll always have them, but that doesn’t mean you’ll always feel unwell.
There may be times when you have very few, if any, symptoms but if your symptoms make you feel unwell it’s important to get medical advice as there are treatments which can help you feel a lot better.
What tests might I need to diagnose Crohn’s or Ulcerative Colitis?
Although Crohn’s Disease and Ulcerative Colitis are different conditions that affect different parts of the digestive tract, doctors are likely to use the similar tests to help them establish the diagnosis.
However, because IBDs are ongoing conditions, some of the tests may need to be repeated from time to time, or extra tests may be needed.
You may need to undergo some tests and investigations to make sure you have a correct diagnosis. The following are common tests for Crohn’s and Ulcerative Colitis:
Blood and stool tests
Blood tests can show whether you have inflammation somewhere in your body and whether you’re anaemic (low haemoglobin). They can also show whether you’re getting the correct vitamins and minerals, and check whether organs such as your liver and kidneys are functioning correctly.
Your poo can also be tested for signs of inflammation by measuring faecal calprotectin, once infection has been ruled out by examining it. If inflammation is confirmed, you may then have an examination to look inside your body such as an endoscopy, x-ray or scan.
Endoscopy
Endoscopy (carried out using an instrument called an endoscope) is the general term for a type of test that lets your Consultant look directly at the inside of your digestive system.
At Benenden Hospital we can carry out the following tests in our purpose-built endoscopy suite:
Gastroscopy: used when your food pipe (oesophagus), stomach, or top part of the small intestine need to be looked at
Colonoscopy: comes into play when your bowel needs to be looked at
Flexible Sigmoidoscopy: used when the Consultant needs to look inside the lower part of your bowel
X-rays and scans
X-rays, including barium follow though, ultrasound, CT scans and MRI scans can also be used in the diagnosis process.
What treatments are available for Crohn’s Disease or Ulcerative Colitis?
Medication is the main treatment for Crohn’s Disease or Ulcerative Colitis:
- Steroids, such as prednisolone, beclomethasone or budesonide
- Immunosuppressants, such as azathioprine or mercaptopurine, which reduce the activity of your immune system to stop it attacking your gut
- Biological medicines, such as infliximab, adalimumab, vedolizumab or ustekinumab If medication can’t control your symptoms, surgery to remove the diseased section of bowel may be necessary.
Can a change in diet help my Crohn’s or Ulcerative Colitis?
There’s no single diet that helps Crohn’s or Ulcerative Colitis. Keeping a food diary can help you find what works for you. Spicy and high fibre foods (like vegetables, nuts and wholegrains) make a lot of people feel worse when they’re in a flare-up - but everyone is different.
The right diet also depends on how your Crohn’s or Ulcerative Colitis affects you. Sometimes a liquid only diet e.g. Modulen IBD will be prescribed so you are getting all the nutrients you need in a form which allows your digestive system to “rest”. This is more commonly used for children or in adults who aren’t keen on taking medication.
How can I find out more about Crohn’s or Colitis?
Crohn’s and Colitis UK offers more than 50 publications on many aspects of Crohn’s Disease, Ulcerative Colitis and other forms of Inflammatory Bowel Disease.
How can I access a private endoscopy service?
Your symptoms can be assessed during a consultation with one of our Gastroenterologists and the diagnosis confirmed through our endoscopy service or radiology department. Get in touch using our online enquiry form or call our Private Patient Team now on 01580 363158 for more details.
Published on 14 May 2021