Inflammatory bowel disease is a term to describe bowel diseases that have an inflammatory cause. Most common are Crohn’s disease and ulcerative colitis. These are often seen in young to middle aged patients and presents with diarrhea, abdominal pain, fever, weight loss and abnormal blood and imaging tests. A CT scan is often ordered to look for the cause of the abdominal pain. This will often allow findings which raise suspicion of inflammatory bowel disease.
The finding of a thickened or inflamed bowel will alert your doctor to the possibility of inflammatory bowel disease. There are however many causes of thickened or inflamed bowel and your doctor will combine this with your clinical history to reach the most likely diagnosis. This will be followed by further testing such as colonoscopy with biopsy to get a precise diagnosis. Crohn’s disease can involve the entire gastrointestinal tract where as ulcerative colitis involves the colon.
If you already have an established diagnosis of inflammatory bowel disease, then the CT scan is often ordered To look for complications of inflammatory bowel disease. Additionally, the CT scan will identify involved segments and the extent of your disease. Strictures or narrowing of the bowel can be identified. These can cause blockages. Sometimes an abnormal communication can occur between the bowel and another site called a fistula. This can occur to another segment of bowel or another organ such as the bladder.
In some cases, inflammatory bowel disease can also lead to abscess and perforation of the bowel. This can be a life threatening complication which needs prompt treatment. A perforated bowel will often lead to something called free air in the abdomen. Normally there is no gas outside the bowel in your abdomen. A perforation will allow air to escape into your abdomen.
An absess is another complication and is basically a walled off pocket of pus. This needs prompt treatment and drainage. Sometimes your doctor will order a CT scan to see how you are responding to treatment with medications. If you have inflammatory bowel disease of your small intestine, then a special CT scan may be ordered to take a closer look at your small bowel called a CT enterography.
Ulcerative colitis can be cured with a removal of your colon or colectomy. Crohn’s disease can not be cured with surgery. Crohn’s disease is treated with medications and surgery when complications arise. Imaging will often guide further treatment and testing.