Procedures

The following procedures or tests can be used to diagnose pediatric inflammatory bowel disease, to check how well a treatment is working and to follow the progress of your Pedi IBD.

  • Lab Tests
  • X-rays
  • Endoscopy

Lab Tests
Lab tests, or blood tests and stool samples, are the tests you will probably have most.
Depending on what treatment you are getting for your Pedi IBD, lab tests may be needed on a regular basis.

Blood tests can be used to look for:

  • low blood counts
  • whether or not your body is taking in the right nutrition
  • inflammation
  • if a treatment is working

Common blood tests include:

  • CBC – Complete Blood Panel to look for anemia and infection
  • ESR – Erythrocyte Sedimentation Rate to look for inflammation
  • Retic Count – to measure how many red blood cells the body is making
  • C Reactive Protein – to look for signs of severe inflammation
  • Comprehensive Metabolic Panel – checks liver, kidney, sugar and protein levels

Stool samples are used to look for:

  • bacteria that causes inflammation
  • blood loss that you don’t know about
  • inflammation

X-rays
X-rays are used to: 

  • help your doctor to decide if you have Pedi IBD
  • find where the disease is in your digestive tract
  • discover parts of your intestine that are swollen or narrow 
  • look for fistulas

The most common x-rays are: 

  • Upper GI series with small bowel follow-through
  • This procedure gives doctors useful information about your esophagus, stomach and small intestine.For this test, your will drink barium, a thick chalky liquid that is used to coat the lining of the small intestine, before x rays are taken. The procedure is not uncomfortable. An upper GI series takes about 1 to 2 hours and can cause you to be constipated or have gray/ white stools for a few days after the procedure.
  • Lower GI series
  • This procedure gives doctors information about your large intestine including the colon and the rectum. For this test, you will have a barium enema where barium, a thick chalky liquid is used to coat the lining of your large intestine which the pediatric radiologist will put into your rectum. You may be a little uncomfortable during the lower GI series because the barium can cause a feeling of fullness or the urge to go the bathroom. Once the procedure is finished, you will be able to go the bathroom and the discomfort will be over. A Lower GI Series takes about 1-2 hours and may cause you to be a little constipated or have gray/white stools for a few days after the procedure.
  • Abdominal CT scan is an x-ray that provides 3 dimensional pictures of your intestine and other abdominal organs.

Endoscopy
Endoscopy gives your doctor more information about your Pedi IBD by using a lighted scope to see inside areas of your intestine. You may be given a mild sedative to make you comfortable during an endoscopy. This will also let the doctor do the procedure as quickly and as safely as possible. 

The four types of endoscopy your doctor can order are:

  • upper endoscopy (or EGD)
  • colonoscopy (or lower endoscopy)
  • flexible sigmoidoscopy
  • capsule endoscopy

Upper endoscopy (or EGD)
A tube is passed in through the mouth and then into the stomach and small intestine.  This gives the doctor information about the esophagus, stomach and duodenum, which is the first part of the small intestine. Small areas of the intestine lining, or biopsies, can be taken during this test to be examined under a microscope.

Colonoscopy (or lower endoscopy) 
A tube is passed into the rectum and moved through the colon allowing the doctor to see and, if needed, biopsy the entire large intestine and the end of the small intestine. The most uncomfortable part of this procedure happens the day before when you will need to drink an unpleasant tasting cleansing liquid. This will make you have a lot of bowel movements to clean out your colon so that the scope will be able to pass through easily.

Flexible sigmoidoscopy 
A flexible scope is passed into the rectum and examines the very end of the intestine, the rectum and the sigmoid colon. This test is usually done when you have already been diagnosed with Pedi IBD.

Video capsule endoscopy 
Involves swallowing a video capsule or mini camera about the size of a vitamin or jellybean.  After the capsule is swallowed the doctor can look at parts of the small intestine that cannot be easily seen in an upper endoscopy.  You will be awake for this procedure.

You will receive specific instructions from your healthcare provider for any test that is scheduled.