Digestive and Gastrointestinal Conditions

Inflammatory Bowel Disease Symptoms and Diagnosis

Symptoms of Inflammatory Bowel Disease

The most common symptoms of inflammatory bowel disease (IBD) are:

  • Cramping pain in the belly
  • Ongoing diarrhea
  • Blood in stool (feces)
  • Weight loss

The symptoms range from mild pain, loose stools or gassy belly to severe, where a child doubles over with pain, loses weight, passes stools more than eight times a day and passes blood. They can vary over time. It's normal for a child to go without symptoms for months or even years and then have symptoms reappear. This can sometimes make it hard for doctors to make a diagnosis.

Other health problems

IBD can lead to other health problems. These can include slowed growth, delayed puberty, weakened bones or lower bone density, anxiety, depression and emotional challenges. Read more about the complications of Crohn's disease or ulcerative colitis .

Inflammatory Bowel Disease Diagnosis

Diagnosis always starts with a detailed health history. To diagnose IBD, the IBD Center  team will ask you for a detailed history of your child's illness. Your child's doctors and other team members will examine your child.

Your child might also have tests, including lab work, body imaging (radiology) and endoscopy.

Lab work

  • Blood tests. Blood tests check for anemia, which can be a sign of heavy internal bleeding in the gut, and high levels of white blood cells and platelets, which can be signs of inflammation. Blood protein levels can tell the team if your child isn't eating enough protein, isn't absorbing enough protein or is losing too much protein because of inflammation. Other tests look for substances in the blood that are signs of inflammation (C-reactive protein test, sedimentation rate).
  • Tests on a stool sample. The team uses these tests to look for blood or signs of infection. Certain stool tests can tell the team if your child has active inflammation.

If your child has IBD and it started before age 5, the IBD Center team might suggest testing for immune deficiencies . Immunologists at Seattle Children's can do this testing.

Body imaging

Pictures that show the inside of your child's belly or pelvic area can help the team learn more about your child's condition. At Seattle Children's, we try to use methods that use low or no radiation, such as ultrasound and MRI (magnetic resonance imaging) .

Some children might need an upper GI (PDF) (gastrointestinal) series of X-rays with a small bowel follow-through or a CT (computed tomography) scan .

Endoscopy

One of the best ways to tell what's happening in your child's intestine is for the doctor to look at it. Doctors can do this by inserting a thin, flexible, lighted tube (endoscope) through your child's mouth or anus.

The tube has a camera that's connected to a computer and a TV monitor. Using the camera, doctors can look for swelling, redness, sores and bleeding. They can even take a tiny sample (biopsy) of the intestine for testing. This can help your child's team diagnose IBD, figure out the type of IBD and tell how much of the intestine is affected.

Your child might have one or more of these types of endoscopy (pronounced end-OSS-cope-ee):

  • Upper endoscopy. The doctor puts the endoscope through your child's mouth to look at their stomach and the first part of their small intestine.
  • Sigmoidoscopy (pronounced sig-moid-OSS-cope-ee). The doctor puts the endoscope through your child's anus to look at only their lower colon.
  • Colonoscopy (pronounced coal-un-OSS-cope-ee). The doctor puts the endoscope through your child's anus to look at their whole colon.

Before these procedures, we give your child medicine that makes them fall asleep (anesthesia). They will not feel any pain and will not move. 

Sometimes, doctors ask children to swallow a pill-like device that carries a tiny camera (capsule endoscopy). (The doctor might also place the capsule in your child's digestive tract using an endoscope). This device takes pictures of the intestine. It passes out of your child's body in stool. Doctors view the pictures on a computer. This lets them see parts of the intestine they cannot see using a regular endoscope.