IBD Diagnostics
Medical tests are essential for accurate diagnosis of IBD and understanding how it has impacted your body. After you were seen by a pediatric gastroenterologist and they think you might have IBD, they will schedule a series of tests to confirm their suspicion.
Gastroscopy/Colonoscopy
When a patient is suspected to have IBD, a gastroscopy and colonoscopy need to be completed to confirm the diagnosis. You, the patient, will be put to sleep for the procedure with some special medication called “general anesthetic”. That means that you will not feel the procedure and will be asleep during it. You will have to get an IV before the test to allow the doctors to give you the special anesthetic medication. While you are asleep, your GI doctor will take the scope and look down your mouth and into your stomach (the way the food goes down - this is not an operation). Following this, they then look up your bum and into your intestines (again, without cutting you open). The end of the scope has a light and a camera, which allows the doctor to see the inside lining of your GI tract (your stomach and intestines). The doctor will also take “biopsies”- tiny tissue samples they will look at under a microscope. After the scope, you will gradually wake up and your doctor will come and talk to you (if you are not still too sleepy) and your parents about what they saw during the scope.
Before you can get the scope done, you will need to do a bowel clean out. This will mean being on a special diet for two days prior to the scope and having to drink some special medication to make you poop lots. The medication that you will have to drink is called either “Picosalex” or “Magnesium Citrate”. It is important that you get all of the poop out prior to the test to allow your doctor to get a good picture of what your intestines look like, or they may need to repeat the scope. Your nurse will go over the preparation with you to tell you exactly how much of the bowel preparation medicine that you need to take before your appointment. We will also ask that you have nothing to eat or drink at least 6 hours before the scopes.
After the procedure you might feel a bit more tired than usual and may feel a bit bloated or uncomfortable; however, you should recover from the procedure quickly. If you are having any pain or fever, it is important to contact your nurse immediately to discuss your concerns.
IN ADDITION TO THE MATERIALS YOU WERE GIVEN, THE FOLLOWING VIDEOS CAN HELP YOU LEARN ABOUT THE UPPER AND LOWER ENDOSCOPY PROCEDURES IN CHILDREN.
Upper endoscopy: Guide for children
Lower endoscopy: Guide for children
These educational videos were created and uploaded to YouTube by Children's Hospital of Wisconsin
Newly Diagnosed Patient Checklist
Once the diagnosis of Inflammatory Bowel Disease has been confirmed by endoscopy your Pediatric IBD team will ask for additional tests to be completed. Here is a list of the tests that are required to be completed once your child’s diagnosis has been confirmed. Not every test listed below may be requested by your physician - every case is different. Additionally, if you are participating in research studies you may be asked to bring in additional samples such as stool and urine. If you have any questions or concerns, please do not hesitate to call the clinic.
Bowel Ultrasound
WHY: This is a quick and non-invasive way to assess for bowel thickening or inflammation in wall of your bowel.
It may be done in clinic by one of the IBD doctors or by our radiologists at the Stollery Children hospital.
Blood Work
WHY: To establish baseline of patient’s condition, prior to starting treatment. Inflammatory markers, nutritional labs and previous immunization levels are checked.
Stool tests
WHY: To rule out infection and check the Fecal Calprotectin level (inflammatory product shed by inflammatory cells in the gut lining into stool - allows us to measure the amount of inflammation in the bowel)
For fecal calprotectin, the first stool of the day is to be collected in an orange top container. The specimen can be frozen until delivery. It can be dropped off at any Dynalife location with its requisition. It is to be collected at the time of diagnosis prior to treatment being started.
Mantoux Test (aka TB test; PPD)
WHY: To confirm that patient doesn’t have tuberculosis or has been exposed to tuberculosis. Some of the medications that patient may be put on to treat their inflammatory bowel disease, could be dangerous if the patient had tuberculosis and we weren’t aware of it. This involves a very small needle prick to the arm, which needs to be looked at 2-3 days later to see if there is a reaction.
To be booked at the public health unit of your convenience. Call public health unit to make arrangements for an appointment. To be done as soon as possible, as results of test may determine treatment options. Letter will be provided to give to public health unit. We also ask that public health unit send copy of immunization letter.
Bone Density
WHY: To get baseline value of how patient’s bones have been growing. This test is very similar to an X-ray or scan.
To be booked by you at your convenience. You call MIC (780) 450-1500, to book. Must be booked at College Plaza location, as it is the only location that will provide a bone density for pediatric patients. To be booked within 1 month of diagnosis.
Small Bowel and Pelvic MRI
WHY: To allow us to assess the small bowel (most of the small bowel is not reached by the scope) and pelvic region if perianal or fistulizing disease is suspected.
Pediatric GI nurses will book the test and call to notify you of your appointment details. The test is booked at University of Alberta or Grey Nuns Hospital. It does require that a patient gets an IV and has to drink a liquid contrast (to help see the bowel) prior to the exam. Preparation for the test is clear fluids only for 3 hours prior to the test and arriving 90 minutes prior to the exam to allow for time to drink the contrast.
Chest X-ray
WHY: To check the lungs.
To be done at any outpatient radiology department.
Remember to ask for MAXILENE (numbing cream) if your child is anxious about the bloodwork. Your doctor would be happy to write you a prescription for you to have your own tube.