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Keep IBD at Bay, One Checkup at a Time
Whether you’re in remission or managing a flare, regular IBD checkups help you stay in control of your condition.
By Karen Appold
Medically Reviewed by Pat F. Bass III, MD, MPH
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Finding a treatment that works for inflammatory bowel disease (IBD) treatment can be a real challenge. However, the challenge doesn’t end once remission begins. Even if you don’t think you need to see your doctor, routinely monitoring inflammatory bowel conditions, such as ulcerative colitis and crohn’s disease, will help manage symptoms while keeping flare-ups at bay.
If you’re newly diagnosed or experiencing flare-ups, you’ll probably see your doctor frequently, such as every two to six weeks. When you’re in remission, once or twice a year is usually enough, said Prabhakar P. Swaroop, MD, director of the Comprehensive Crohn's and Colitis Program at UT Southwestern Medical Center in Dallas.
Preparing For Your Checkup
Make the most of the limited time you have in your doctor’s office by coming prepared. Between visits, keep a simple diary of signs and symptoms of active Crohn's disease or ulcerative colitis and how you managed them, and bring it with you. Note any abdominal pain, diarrhea, blood in the stool, nausea, vomiting, and weight loss. Of course, if these symptoms are occurring regularly before a scheduled checkup, call your gastroenterologist so that you can be evaluated sooner than planned.
Reviewing your symptoms and doing routine laboratory tests enable your doctor to evaluate your IBD status and make any necessary changes to your plan. "If you don't have any symptoms, most likely your Crohn's disease is under control, and you should maintain the current dosage of your medication or perhaps you could decrease it," said David B. Myers, MD, board certified gastroenterologist in practice in Brunswick, Ohio.
On the other hand, abdominal pain, diarrhea, and rectal bleeding can be signs that your Crohn's is inflamed. "In this instance, your doctor will most likely ask you to increase your medication's dosage," Dr. Myers said.
Some symptoms might require further investigation. For instance, nausea or vomiting can indicate scarring and potential blockage and inflammation of the intestine, a risk of Crohn's. If you have those symptoms along with pain, your doctor may order a CT scan of your abdomen, Myers added.
Also use each visit to gain a better understanding of your condition. "If you have read or heard something about Crohn's disease that you don't understand or wonder if it's correct, you should mention that during your office visit," Myers said. Your gastroenterologist can answer questions and comment on the accuracy of the information.
RELATED: Connecting With Crohn's How Support Groups Can Help
A Closer Look at Routine Testing
Various tests give your doctor a more complete picture -- sometimes literally -- of how your body is responding to treatment and how your Crohn’s or ulcerative colitis is (or isn’t) progressing.
Blood tests.Typically, you can expect to have blood work two to three times per year to help determine if your disease is under control with your current treatment, Myers said. Your blood sample might be tested for:
- Complete blood count (CBC); looking at your red blood cell count will show if you're anemic; your white blood cell count can signal inflammation or infection.
- Kidney and liver function to make sure these organs are working properly
- An electrolyte panel to check for dehydration and medication side effects
- Levels of C-reactive protein and your sedimentation rate, two indicators of inflammation
- Vitamin D and vitamin B12 to look for any deficiencies
Stool tests.Certain proteins found in stool can signal inflammation.
Scans.Occasionally, radiologic images might be done to determine if your Crohn's is active. This involves taking pictures that show the inside of your intestines. Types of tests include ultrasounds, MRIs, and CT scans.
Endoscopic tests.IBD is typically diagnosed with a colonoscopy, a diagnostic and screening test that uses a scope with a camera on the end to take images inside your colon and lower small intestine. Because a colonoscopy is an invasive and expensive procedure, it is repeated about every five years after your diagnosis, Myers said.
RELATED: 'It's Not Me, It's You': Crohn's Disease and Toxic Friendships
Once you’ve had IBD for 10 to 20 years, your doctor may order a colonoscopy every two to three years because you're at increased risk for developing colon cancer.
You will need to go on a liquid diet for one to two days before the procedure and take laxatives the night before to cleanse your colon and allow for a clear and accurate view of the bowel wall during the colonoscopy. You’ll be sedated for this test.
You might also have other types of tests involving a scope to routinely monitor IBD. A sigmoidoscopy is used to evaluate the lower one-half to one-third of the colon. It can monitor your disease as well as show how you’re reacting to medication. Because it is a short procedure with less discomfort than a colonoscopy, you don't have to be put to sleep. Preparation usually includes having one or two enemas before the exam.
An upper endoscopy can evaluate your esophagus, stomach, and upper small bowel, areas that can also be affected by Crohn's. You will have to fast after midnight to prepare for this test.
Work with your medical team to create the right checkup timetable for you. Then stick to the schedule, even if you’re feeling great, to keep your IBD in check.
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