Diagnosis and Testing

In a small intestine barium x-ray (also called “small bowel follow-through” or “small bowel meal”), you would drink a white, chalky liquid called barium. The barium allows for better visualization of the digestive tract with x-rays.

As the barium flows through the digestive tract, the technician takes a series of pictures and sometimes video. This test is not used very much anymore.

One up-and-coming technology for evaluation of IBD is ultrasound, which uses high-frequency sound waves to create images. However, taking good quality ultrasound pictures of the intestine is a challenge and requires very specialized training. It involves a lot of detailed study and is not readily available in Canada. 

Watch the video below to learn about the use of ultrasound imaging techniques as a non-invasive approach to diagnosis and testing for Crohn's and colitis. 

Speaker: Dr. Hughie Fraser (MD, FRCPC) is an Assistant Professor in the Department of Medicine and Division of Digestive Care and Endoscopy at Dalhousie University in Halifax, and a gastroenterologist at the South Shore Regional Hospital in Bridgewater.

A CT scan is a sophisticated x-ray device. Enterography is a word for taking pictures of the intestines. Sometimes the test is given with an intravenous contrast. CT enterography is quite common.

What is this test used for?

One promising technique for looking at the small intestine is MR enterography. This is the use of an MRI machine to take pictures of the intestines. 

​MR enterography shows inflamed areas of the intestines quite vividly with a white colour. MR enterography is also helpful for telling the difference between inflamed areas and scar tissue. MR enterography does not use radiation. 

How is the test done?

In MR enterography, an MRI uses magnetic waves to take images of your insides. It involves a large machine with a tunnel inside. You would lie on your back and slide through the tunnel as the images are taken. 

Preparing for an MRI

Here are some steps you will need to take before having an MRI:

• You need to remove all metal that can be magnetized, such as jewelry

• Typically, you will need to drink some fluid (sometimes barium or sorbitol) before the test, which makes it easier to see the walls of the intestine 

• You will also be given intravenous contrast called gadolinium, which is different from the contrast you might receive with a CT 

• During the MRI, you may be asked every now and then to hold your breath. This allows you to hold still so they can take the series of pictures.

• The images seen on MR enterography are very high resolution and show a lot of detail. One advantage of MR enterography (and also of CT) is it allows the radiologist to see the full thickness of the intestinal wall. This can be very useful information.