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Part 2 · Getting treatment today · 9/22

Tests, without the stress

What each test is for, and what really happens.

Why so many tests?Because you can feel well and still have inflammation. Tests check that the bowel is really healing, and they are less and less unpleasant.

The blood test

No preparation*5 minutes

What it is for : Spotting inflammation (CRP), anaemia and deficiencies, and checking that the treatment is well tolerated (liver, kidneys, blood cells).

What happens : A simple blood test. *Sometimes after fasting. The level of the drug in the blood can also be measured to adjust the dose.

A normal result does not mean the bowel is calm: CRP sometimes stays normal even during a flare.

Calprotectin

StoolPainless

What it is for : Measuring bowel inflammation in the stool. It is the simplest test to know whether the disease is active.

What happens : A small pot of stool taken back to the lab. Result in µg/g: under 50, reassuring; between 50 and 250, to be watched; over 250, inflammation likely.

First stool of the morning, same lab, no ibuprofen beforehand. In France, it is reimbursed 2 times a year when prescribed by the gastroenterologist or paediatrician, if there is no blood in the stool and no raised CRP; otherwise you pay for it yourself, often 40 to 50 €.

Bowel ultrasound

No radiationNo preparation15 to 30 min

What it is for : Seeing whether the bowel wall is thickened or inflamed, and following the effect of a treatment.

What happens : A probe with gel placed on the abdomen, like a pregnancy ultrasound. The result is given straight away.

Used more and more, but not yet available everywhere: ask your gastro.

Colonoscopy

Short anaestheticPreparation

What it is for : Looking directly inside the colon and the end of the ileum, taking small samples (biopsies), and monitoring the risk of cancer.

What happens : Under a short general anaesthetic (with an anaesthetic consultation beforehand): you feel nothing. The hardest part is the preparation: a liquid to drink, often in two goes (the evening before and the morning).

For the preparation: drink it chilled, and eat a low-fibre diet (no fruit or vegetables) in the days before.

MR enterography

No radiation30 to 45 min

What it is for : Seeing the whole small bowel, which colonoscopy cannot reach: strictures, fistulas, abscesses. A pelvic MRI is also used for fistulas near the anus.

What happens : You drink a large volume of liquid before the scan, then lie in a noisy tunnel, with an injection.

If you are afraid of enclosed spaces, say so beforehand: they can help you relax.

Capsule endoscopy

No anaesthetic8 to 12 h

What it is for : Filming the inside of the small bowel, where other tests see poorly.

What happens : You swallow a capsule containing a tiny camera. It films during the day, then passes out naturally in the stool.

Be careful if you have a stricture: the capsule can get stuck. A test capsule that dissolves is often used first.

CT scan

QuickX-rays

What it is for : Mainly in A&E: quickly looking for an abscess, a blockage or a perforation.

What happens : A few minutes lying in a ring, often with an injected contrast agent.

It uses X-rays: for regular follow-up, MRI or ultrasound is preferred.

The usual follow-up schedule
Every 3 to 6 monthsBlood test and calprotectin, often.
About once a yearUltrasound or MRI depending on your disease.
As neededColonoscopy, including to monitor the risk of cancer when the disease has affected the colon for several years.
Good to knowThe schedule depends on your disease and your treatment: your gastro adapts it. Don't hesitate to ask what each test is for and when you will get the result.