A thorough physical exam and a series of tests are necessary to diagnose ulcerative colitis.
The gold standard to confirm a diagnosis is a colonoscopy with biopsies of the colon and rectum. This should be mandatory if ulcerative colitis is suspected.
A colonoscopy entails a doctor inserting a long, flexible, lighted tube connected to a computer and TV monitor called an endoscope into the anus to see the inside of the colon and rectum.
This enables the doctor to detect any inflammation, bleeding or ulcers on the colon wall. The doctor may also decide to conduct a biopsy, which entails taking a sample of tissue from the lining of the colon to view under a microscope.
In addition, the patient may require a barium enema X-ray of the colon. This procedure involves filling the colon with a chalky white solution called barium, which shows up white on X-ray film.
It provides a clear view of the colon and of any ulcers or abnormalities that might be present. Other tests may include blood and stool tests.
Blood tests can be done to check for anaemia, which would indicate bleeding in the colon or rectum. If blood tests uncover a high white blood cell count, this would indicate inflammation somewhere in the body.
Testing a stool sample would enable doctors to confirm whether there is bleeding or infection in the colon or rectum.
Reviewed by Dr Ismail Moola, MBCHB (UCT) FCP (SA) Cert Gastro Phys (SA). Specialist Physician / Gastroenterologist, Netcare Sunninghill Hospital; Lecturer, Department of Internal Medicine, Division of Gastroenterology, University of the Witwatersrand.