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Go Ask Mom

Duke Medicine: Diagnosing inflammatory bowel disease

Posted October 18, 2010 8:01 p.m. EDT

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