Crohn’s disease has a high rate of misdiagnosis What tests are done for inflammatory bowel disease, some say colonoscopy, some say small colonoscopy, and some say CT or MR?Inflammatory bowel disease is a disease that can involve the entire gastrointestinal tract, including the esophagus, stomach, duodenum, small bowel, and large bowel, and manifests itself as an ulceration of the gastrointestinal tract. Because this ulceration is often not characteristic, it is difficult to diagnose with only one or two tests. Currently, less than 20% of patients can be diagnosed with one test alone (e.g., an endoscopy, pathology, or imaging). The disease requires a combination of tests for diagnosis, each of which provides only partial clues. Take endoscopy, for example. If you do gastroscopy, you can only see the stomach and esophagus with or without lesions, and colonoscopy can generally only see the large intestine with or without lesions; and the small intestine is five or six meters long, if the lesion is in the small intestine, gastroscopy and colonoscopy can not be seen, and need to specialize in double balloon small enteroscopy or capsule endoscopy. Therefore, what tests need to be done depends on the site of the lesion, and the tests chosen for different sites are different. Secondly, when an intestinal ulcer is detected endoscopically, it can be difficult for us to determine what is causing it. There are a variety of diseases that cause intestinal ulcers, including tumors, tuberculosis, lymphoma, etc., and their manifestations may be the same, and the patient’s clinical manifestations are all tummy pains, and then it is necessary to combine with a lot of other evidences to determine what kind of disease the ulcers are actually caused by. In addition, because the disease is not very well characterized, there is sometimes confusion in the diagnosis. For example, Crohn’s disease is very similar to intestinal tuberculosis, and sometimes it is mistaken, but the treatment programs for both are different, and very often the diagnosis is slowly corrected in the course of treatment. Therefore, in the clinic, the diagnosis of Crohn’s disease is allowed to make mistakes, because even if a pathological examination is done, the report can only prove that it is an inflammation, and often no characteristic lesions can be found, and laboratory tests can only find out whether the inflammation is active or not, but except for tumors, all other diseases can lead to inflammatory lesions, so it is sometimes difficult to differentiate between tuberculosis or Crohn’s disease or leukoencephalopathy, and so on. The misdiagnosis rate for Crohn’s disease is high, at least 40-50%, but an experienced doctor will make fewer such mistakes. Is capsule endoscopy more comfortable and can it be the test of choice for inflammatory bowel disease? Generally speaking, inflammatory bowel disease lesions are mostly in the ileocecal region, that is, at the junction of the large intestine and small intestine, leukocele, intestinal tuberculosis caused by ulcerative disease Huangcai and Yuya supper Yin轿鳎裕頤怯畔妊≡竦氖瞧胀ǖ拇蟪担耗夷诰祷]蟋溪狄话悴蛔魑籽 ＞8雇吹牟∪耍偃偃绱蟪导觳榉(11)只孛げ欣げQ瘛(10)炊嘶爻Σ课挥胁 “洌耸辈趴悸鞘 The first step in the process is to create a new product, which is to be used as a new product, and the second step in the process is to create a new product, which is to be used as a new product, and the third step in the process is to create a new product, and the third step in the process is to create a new product, and the third step in the process is to create a new product, and the third step in the process is to create a new product, and the fourth step in the process is to create a new product. (Contempt to support the australia astragali shaanxi shaking σ准ぷ汾险鳎ㄒ郧敖形賦 neurosis). Usually, when the end of the small intestine to see a lesion, or see the large intestine has a lesion at the same time suspected that the small intestine has a lesion, you can consider the first capsule endoscopy without small enteroscopy (unless the patient has a clear intestinal obstruction manifestations), on the one hand, small enteroscopy is more expensive, need to be more than 10,000 yuan, while the capsule is only 3800 yuan; on the other hand, is the small intestine is five or six meters long, the examination is more troublesome, the patient needs to hospitalized as a The patient needs to be hospitalized for general anesthesia. Is CT and MR useful in the diagnosis of inflammatory bowel disease? CT/MR can visualize the lesions of intestinal stenosis, especially the CTE examination which is widely used before now, and is very helpful in determining the gastrointestinal lesions in the whole abdominal cavity. However, there is one major shortcoming – it cannot be biopsied for pathologic diagnosis. For active lesions, imaging often does not see erosive ulcers in the intestinal mucosa, only narrowing of the bowel, thickening of the bowel wall, or complications such as intestinal fistulae. For lesions that enter remission, imaging also often does not see whether the mucosa is still diseased, and the only way to know the changes in the intestinal mucosa is through colonoscopy. Therefore, CT/MR has a limited role in the diagnosis of inflammatory bowel disease and is more often used when complications are suspected. How long does it usually take for a patient with Crohn’s disease to be diagnosed? For experienced physicians, a definitive diagnosis can be made in more than 80% of cases within a week or ten days after a thorough and comprehensive examination. The so-called comprehensive diagnosis means that after the patient arrives at the hospital, it takes five or six days to do endoscopy, pathology, imaging, laboratory tests, etc. If the patient sees this doctor today, he or she will see him or her tomorrow. If the patient sees this doctor today and that doctor tomorrow, it is not only a waste of time and money, but also an increase in the rate of misdiagnosis. Ulcerative colitis and Crohn’s disease are both inflammatory bowel diseases, but there is a misdiagnosis rate of about 10% between them. It is sometimes difficult to distinguish between the two, especially in atypical cases. Is it called Crohn’s disease or ulcerative colitis? Currently, there is a foreign term for intermediate inflammatory bowel disease (IBD), which is neither Crohn’s disease nor ulcerative colitis, and the final determination of whether it is Crohn’s disease or ulcerative colitis is made based on changes in the lesions or the course of treatment. The general principles of treating inflammatory bowel disease are similar, but the treatment plan is different for different disease stages, different activity levels, and different sites, and we place great emphasis on individualized treatment. Like the rectal type of ulcerative colitis, the left hemicolon type and to the extensive type of transverse colon, its treatment plan is completely different; Crohn’s disease of the esophagus and Crohn’s disease of the intestinal tract, the treatment is different, and some of the Crohn’s disease of the small bowel and the Crohn’s disease of the large bowel, its treatment is different. Therefore, while it is best to be able to confirm the diagnosis in time and then treat it, many inflammatory bowel diseases are revised in the course of treatment, gradually clarifying the diagnosis, and then constantly adjusting the medication as the condition changes.