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Laboratory assessment of inflammatory bowel disease

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Abstract

Presently there are no specific laboratory tests to diagnose inflammatory bowel disease (IBD). Nonspecific tests to differentiate diarrhea due to mucosal injury from that occurring in patients with normal bowel mucosa (eg, fecal occult blood, leukocytes, etc) are not helpful. Tests to exclude infectious agents are very important, since the clinical and radiological appearance of these may mimic IBD, and patients with IBD may suffer from superinfection. There are no laboratory tests which can differentiate Crohn's colitis from ulcerative colitis (UC). The tests used in the assessment and management of severely ill patients (Hgb, WBC, electrolytes, etc) are important, since abnormalities need to be corrected on an ongoing basis. The tests used to assess nutritional status are of little clinical value, since “clinical assessment” is as good as the laboratory assessment. Estimation of disease activity by tests is rarely better than the juudgment of the clinician. Workup for malabsorption in Crohn's disease and the assessment of absorptive capacity of the terminal ileum are important for proper planning of management. Laboratory tests are also useful in clarifying the nature of some complications (eg, anemias and joint diseases).

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  1. Department of Medicine and Physiology, the Gastrointestinal Diseases Research Unit, Queen's University, Kingston, Ontario, Canada

    I. T. Beck MD, FRCP(C)

  2. Department of Medicine and Physiology, the Gastrointestinal Diseases Research Unit, Hotel Dieu Hospital, Kingston, Ontario, Canada

    I. T. Beck MD, FRCP(C)

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Supported by grant MT.4257 from the Medical Research Council of Canada and by the Physicians' Services Incorporated Foundation.

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Beck, I.T. Laboratory assessment of inflammatory bowel disease. Digest Dis Sci 32 (Suppl 12), S26–S41 (1987). https://doi.org/10.1007/BF01312461

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