Disease
Figure 2
Assess inflammatory status
A
Assess symptoms/signs
• Fever
• Abdominal pain
• GI bleeding
• Localized tenderness
• Weight loss
• Joint pain
• Cutaneous signs
Perform clinical lab testing:
• CBC
• CRP
• CMP
• Fecal calprotectin
• ESR
Select imaging
modalities
(if indicated)
Perform
endoscopy
Identify symptoms
without inflammatory
markers
Identify symptoms
with inflammatory
markers
b
Perform CT-
enterography OR
magnetic resonance
enterography
a
a
Selection depends on local expertise and experience with imaging modalities. Magnetic
resonance enterography is preferred due to the reduction in ionizing radiation, particularly
for younger patients. If patient is less than 50 years of age, we suggest using magnetic
resonance enterography.
b
Consideration could be given as to whether to make treatment decisions based on
inflammatory markers versus confirming with colonoscopy. is may depend on whether
there was historically good correlation between the biomarker selected and colonoscopy in
the specific patient.
