Diagnosis of chronic inflammatory bowel disease

Table of contents

1 Introduction: The long journey to diagnosis
2. frequent delays in the diagnosis of IBD
3. comparison of Crohn's disease and ulcerative colitis
4. IBD or another disease? Differences to irritable bowel syndrome and food intolerances
5 Average time to diagnosis - What do the figures say?
6. what can you do to speed up the diagnosis?
7. community experiences: "My path to diagnosis"
8 Conclusion: Education and persistence help!

The picture shows a young girl sitting on your gray couch and holding her stomach. She has abdominal pain that is non-specific. Abdominal pain is also a symptom of chronic inflammatory bowel disease. In the background you can see a bookshelf and a light-colored wooden side table with a green plant in a metal vase. The picture symbolizes the long road to the diagnosis of IBD, i.e. chronic inflammatory bowel disease. This picture is part of a blog post that explains the journey to diagnosis of Crohn's disease and ulcerative colitis and gives tips on how to speed up the diagnosis.

1 Introduction: The long journey to diagnosis

Many sufferers of Crohn's disease or ulcerative colitis report that it is Months or even years until they received the correct diagnosis. Why is that? And what can you do to get a diagnosis faster? In this article, we explain the hurdles on the way to the correct diagnosis and give tips on what to look out for.

2. frequent delays in the diagnosis of IBD

1. unspecific symptoms

Diarrhea, abdominal pain and fatigue can have many causes - from irritable bowel syndrome to stress.
Initially, many sufferers think they have a harmless digestive disorder.

2. confusion with other diseases

Irritable bowel syndrome: Without laboratory results or a colonoscopy, IBD is often dismissed as a "functional digestive disorder".
Food intolerances: Sufferers often try different diets before going to the doctor.
Gastrointestinal infections: Chronic diarrhea is often initially misunderstood as an infection.

3. insufficient examinations by general practitioners

Not all GPs immediately recognize the suspicion of IBD.
Often there are only general recommendations such as "more fiber" or "reduce stress".
A referral to a gastroenterologist is often only made after a long period of suffering.

4. waiting times for specialists

Appointments with gastroenterologists can take months.
Urgency is often not recognized if the symptoms are not classified as "acute".

5. lack of or inadequate diagnostics

Not every doctor directly initiates a Stool sample (calprotectin) or Colonoscopy.
Without clear laboratory values, the need for an invasive examination is often not recognized.

3. comparison of Crohn's disease and ulcerative colitis

Symptom	Crohn's disease	Ulcerative colitis
Inflammation area	Can affect the entire digestive tract	Exclusively in the large intestine
Depth of inflammation	Transmural (all intestinal wall layers)	Superficial (mucosa)
Diarrhea	Usually without blood, often mushy	Bloody, slimy diarrhea
Pain	Often on the right in the lower abdomen	Mostly left-sided pain
Fistulas & abscesses	Frequently	Rare

In addition to these digestive problems, IBD sufferers can also have complaints outside the bowel:

Joint pain (Arthritis)
Eye inflammation (uveitis)
Skin problemse.g. redness or ulcers

4. IBD or another disease? Differences to irritable bowel syndrome and food intolerances

CED vs. irritable bowel syndrome

Feature	CED	Irritable bowel syndrome
Diarrhea	Chronic, often with blood	Alternates between constipation and diarrhea
Pain	Stronger, often localized	Diffuse, but without inflammation
Inflammation	Detectable (blood, stool, colonoscopy)	No signs of inflammation
Extraintestinal symptoms	Possible (skin, joints, eyes)	No

CED vs. food intolerances

Lactose/fructose intolerance: Symptoms occur immediately after eating certain foods.
CED: Symptoms often occur independently of food, especially in episodes.
Histamine intolerance: Often causes headaches, reddening of the skin or palpitations, which is not typical for IBD.

5 Average time to diagnosis - What do the figures say?

Studies show that the Average time to CED diagnosis between 1-5 years is located.
Crohn's disease lasts longer than ulcerative colitis, as the symptoms appear more gradually.
Many patients have already consulted several doctors before they receive a correct diagnosis.

6. what can you do to speed up the diagnosis?

Document symptoms: Keep a diary with the frequency of diarrhea, pain and accompanying symptoms.
Ask specifically for tests: Insist on a Calprotectin stool test, blood values (CRP, BSG, iron deficiency) and, if necessary, a colonoscopy.
Consider changing doctor: If you are not taken seriously, get a second opinion.
Emphasize necessity: This is the way to indicate severe impairments in everyday life in order to obtain a faster referral to a specialist.

7. community experiences: "My path to diagnosis"

"My doctor told me I just had stress. It wasn't until two years later that I had a colonoscopy - and I had ulcerative colitis." - Lisa, 27

"I always had fatigue and diarrhea, but no blood. They told me it was irritable bowel syndrome. In the end it was Crohn's disease." - Jonas, 32

8 Conclusion: Education and persistence help!

The diagnosis of IBD often takes a long time because symptoms are misjudged or trivialized. If you document your symptoms and actively ask for specific tests, you can shorten the waiting time and receive targeted treatment more quickly.

If you would like to find out more about the different methods of diagnosing IBD, read our article: Diagnosis of IBD: These methods are available.