In order to reach a diagnosis for digestive disorders, the Doctor needs to take a thorough and accurate medical history of the patient, noting the symptoms he has experienced and any other pertinent information. A physical exam is also done to help assess the problem more completely.
In some cases the patient need to undergo a more extensive diagnostic evaluation. This may include lab tests, imaging tests, and/or endoscopic procedures. These tests may include any, or a combination of, the following:
- Faecal occult blood test. A faecal occult blood test checks for hidden (occult) blood in the stool.
- Stool culture. A stool culture checks for the presence of abnormal bacteria in the digestive tract that may cause diarrhoea and other problems.
- Barium beefsteak meal. During this test, the patient eats a meal containing barium (a metallic, chalky liquid used to coat the inside of organs so that they will show up on an X-ray). This allows the radiologist to watch the stomach as it digests the meal. The amount of time it takes for the barium meal to be digested and leave the stomach gives the healthcare provider an idea of how well the stomach is working and helps to find emptying problems that may not show up on the liquid barium X-ray.
- Colorectal transit study. This test shows how well food moves through the colon. The patient swallows capsules containing small markers which are visible on X-ray. The patient follows a high-fiber diet during the course of the test. The movement of the markers through the colon is monitored with abdominal X-rays taken several times 3 to 7 days after the capsule is swallowed.
- Computed tomography scan (CT or CAT scan). This is an imaging test that uses X-rays and a computer to make detailed images of the body. A CT scan shows details of the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
- Defecography is an X-ray of the anorectal area that evaluates completeness of stool elimination, identifies anorectal abnormalities, and evaluates rectal muscle contractions and relaxation.
- Lower GI (gastrointestinal) series (also called barium enema). A lower GI series is a test that examines the rectum, the large intestine, and the lower part of the small intestine. Barium is given into the rectum as an enema. An X-ray of the abdomen shows strictures (narrowed areas), obstructions (blockages), and other problems.
- Magnetic resonance imaging (MRI). MRI is a diagnostic test that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. The patient lies on a bed that moves into the cylindrical MRI machine. The machine takes a series of pictures of the inside of the body using a magnetic field and radio waves. The computer enhances the pictures produced. The test is painless, and does not involve exposure to radiation. Because the MRI machine is like a tunnel, some people are claustrophobic or unable to hold still during the test. They may be given a sedative to help them relax. Metal objects cannot be present in the MRI room, so people with pacemakers or metal clips or rods inside the body cannot have this test done. All jewelry must be removed before the test.
- Magnetic resonance cholangiopancreatography (MRCP). This test uses magnetic resonance imaging (MRI) to view the bile ducts. The machine uses radio waves and magnets to scan internal tissues and organs.
- Oropharyngeal motility (swallowing) study. This is a study in which the patient is given small amounts of a liquid containing barium to drink with a bottle, spoon, or cup. A series of X-rays is taken to evaluate what happens as the liquid is swallowed.
- Radioisotope gastric-emptying scan. During this test, the patient eats food containing a radioisotope, which is a slightly radioactive substance that will show up on a scan. The dosage of radiation from the radioisotope is very small and not harmful, but allows the radiologist to see the food in the stomach and how quickly it leaves the stomach, while the patient lies under a machine.
- Ultrasound is a diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through them.
- Colonoscopy is a procedure that allows the doctor to view the entire length of the large intestine (colon). It can often help identify abnormal growths, inflamed tissue, ulcers, and bleeding.
- Endoscopic retrograde cholangiopancreatography (ERCP). ERCP is a procedure that allows the doctor to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. The procedure combines X-ray and the use of an endoscope.
- Esophagogastroduodenoscopy (also called EGD or upper endoscopy). An EGD (upper endoscopy) is a procedure that allows the doctor to examine the inside of the oesophagus, stomach, and duodenum with an endoscope. This is guided into the mouth and throat, then into the oesophagus, stomach, and duodenum. The endoscope allows the doctor to view the inside of this area of the body, as well as to insert instruments through the scope for the removal of a sample of tissue for biopsy (if necessary).
- A sigmoidoscopy is a diagnostic procedure that allows the doctor to examine the inside of a portion of the large intestine, and is helpful in identifying the causes of diarrhoea, abdominal pain, constipation, abnormal growths, and bleeding. Other procedures
- Anorectal manometry. This test helps determine the strength of the muscles in the rectum and anus. These muscles normally tighten to hold in a bowel movement and relax when a bowel movement is passed. Anorectal manometry is helpful in evaluating anorectal malformations and Hirschsprung disease, among other problems.
- Oesophageal manometry. This test helps determine the strength of the muscles in the oesophagus. It is useful in evaluating gastroesophageal reflux and swallowing abnormalities.
- Oesophageal pH monitoring. An oesophageal pH monitor measures the acidity inside of the oesophagus. It is helpful in evaluating gastroesophageal reflux disease (GERD).
- Gastric manometry. This test measures electrical and muscular activity in the stomach. The doctor passes a thin tube down the patient’s throat into the stomach. This tube contains a wire that takes measurements of the electrical and muscular activity of the stomach as it digests foods and liquids. This helps show how the stomach is working, and if there is any delay in digestion.
- Magnetic resonance cholangiopancreatography (MRCP). This test uses magnetic resonance imaging (MRI) to obtain pictures of the bile ducts. The machine uses radio waves and magnets to scan internal organs and tissues.