Go Ask Mom

Go Ask Mom

Duke Medicine: Diagnosing inflammatory bowel disease

Posted October 18, 2010

When a child has persistent abdominal pain, particularly those with accompanying weight loss, it might be time to call in an expert. Dr. Nancy McGreal, a pediatric gastroenterologist at Duke, explains how she diagnoses inflammatory bowel disease:

Inflammatory bowel disease encompasses a group of chronic intestinal conditions including Crohn’s disease, ulcerative colitis and indeterminate colitis.

IBD may occur at any age, affecting both children and adults. Making a diagnosis of IBD can sometimes be difficult, as there is no single test that alone determines if an individual has one of these conditions.

Rather, the diagnosis of IBD is a bit like a puzzle in which health care providers must piece together:

  • A patient’s symptoms
  • Laboratory blood tests
  • Endoscopic exams (what the intestines look like on the inside through a camera).
  • Pathology results (what the tissue specimens collected during endoscopy look like under the microscope)
  • Radiology results (x-ray tests)

Listening carefully to a patient’s description of her symptoms is key to determining how to direct further testing towards a possible diagnosis of IBD.

IBD may present with a variety of different symptoms including: weight loss, abdominal pain, diarrhea, bloody stool, nausea, or vomiting, as well as growth failure and pubertal delay in children.

Signs or symptoms suggesting a diagnosis of IBD may guide a heath care provider to pursue additional tests, which might include a genetic tests, an endoscopy, a colonoscopy or other tests.

To read more about the diagnosis of inflammatory bowel disease, read the full article in the Your Child's Health section of


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  • shall6 Oct 19, 2010

    So glad things worked out for you!


  • logan45 Oct 19, 2010

    Thank you reporting this. My son was diagnosed with Crohn's when he was 18 months old. Pediatricians were reluctant to diagnose him with it saying he was too young. It took about two months to get to Duke to get diagnosed. HE had almost stopped walking due to the pain, so we also had to look at orthopedic reason as the connection wasn't made with the bloody stools and the pain. In diagnosing his Crohn's, they did almost every test during emergency room visit to rule out anything else it could be. Bones Scans, MRI's, X-rays, all kinds of blood tests. Alot for an 18 month old. Finally when we got into the Peds GI at Duke, they did a colonoscopy and diagnosed Crohn's, Then they had to do an upper GI to see to what degree of involvement there was.
    He takes meds 3x's a day but Thankfully he is in remission and has only had that one flare. Love Duke Peds GI!