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  • Q&A with Australian Health Practitioners

    Is a colonoscopy an effective diagnostic measure for Crohn's disease?

    Related Topics
    Crohn's Disease & Ulcerative Colitis Digestive Health
    • 2 answers
    • Dr Andrew Sutherland
    • Prof Andrew Day
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    Dr Andrew Sutherland

    Colorectal Surgeon (Bowel)

    I am a specialist colorectal surgeon treating a range of bowel diseases and am committed to providing the best of care for all patients. It … View Profile

    Crohn's disease is a complex inflammatory bowel disease that can effect the bowel anywhere from the mouth through the oesophagus, stomach, duodenum, small bowel, large bowel, rectum and anus.  The symptoms can vary depending on the site or sites of disease and the extent (length) and severity of disease at each site.  This can make diagnosing Crohn's disease difficult.

    Colonoscopy examines the entire colon and often can be extended a short distance into the end of the small bowel (terminal ileum).  This covers the areas where Crohn's disease is most ikely to occur and therefore will usually be able to make the diagnosis if there is significant disease present.  If the Crohn's disease only effects the small bowel in other locations then colonoscopy will not be able to make the diagnosis.  

    In addition if the inflammation is very mild then even biopsies may not be able to distinguish Crohn's disease from other causes of inflammation.  

    If the diagnosis of Crohn's is strongly suspected but the colonoscopy has not confirmed the diagnosis then other tests may be required.

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    Prof Andrew Day

    Paediatrician

    Further to the excellent answer above, the patterns of Crohn disease in children can be quite different to that seen in adults. Around two thirds of the time in children, the upper gut is involved in Crohn disease (oesophagus, stomach or  the first parts of the small bowel). 

    Consequently, international guidelines include upper endoscopy and small bowel imaging along with colonoscopy as the key diagnostic tests in young people with suspected Crohn disease. 

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