Inflammatory Bowel Disease (IBD)

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Specialists at Houston Methodist Lynda K. and David M. Underwood Center for Digestive Disorders take a multidisciplinary approach to the diagnosis and treatment of simple to complex inflammatory bowel disease cases. We use research-backed diagnostic tools and state-of-the-art equipment to care for patients from diagnosis through recovery and beyond.


Inflammatory bowel disease (IBD) is a gastrointestinal (GI) condition that includes both Crohn’s disease and ulcerative colitis. Inflammation occurs in the digestive tract when a genetically predisposed individual is exposed to different environmental factors that include smoking, antibiotic use, gastrointestinal infections and diet.


When inflammation occurs in the small and large intestines, painful, chronic symptoms may develop. These symptoms can include weight loss, diarrhea, abdominal pain, rectal bleeding or other life-threatening complications.


If you have GI distress accompanied by risk factors, such as a low-fiber diet or family history, consult an Underwood Center gastroenterologist.


Houston Methodist Hospital is ranked No. 5 by U.S. News & World Report for Gastroenterology & GI Surgery. U.S. News & World Report has also named Houston Methodist Hospital the No. 1 hospital in Texas every year since the award began and one of the nation’s best as a nationally ranked Honor Roll hospital.

IBD Conditions We Treat

IBD Signs, Diagnosis & Treatment

What are the signs and symptoms of inflammatory bowel disease?

Contact our gastroenterologists for testing if you have any of the symptoms below:

  • Abdominal pain and cramping
  • Blood in your stool
  • Diarrhea
  • Fever and fatigue
  • Weight loss or reduced appetite

How is inflammatory bowel disease diagnosed?

To help confirm a diagnosis of IBD, you may need a combination of tests and procedures:


  • Your doctor may suggest blood tests to check for anemia — a condition where there aren't enough red blood cells to carry adequate oxygen to your tissues — or to check for signs of infection from bacteria or viruses.
  • You may need to provide a stool sample — so that your doctor can test for hidden (occult) blood or organisms, such as parasites, in your stool and for inflammation.
  • Endoscopic (thin, flexible tube with a light and camera attached) procedures.
  • A colonoscopy exam allows your doctor to view your entire colon with an endoscope. During the procedure, we may take small samples of tissue (biopsy) for analysis.
  • A flexible sigmoidoscopy exam allows your doctor to examine the rectum and sigmoid — the last portion of your colon — with an endoscope. If your colon is severely inflamed, your doctor may perform this test instead of a full colonoscopy.
  • An upper endoscopy procedure allows your doctor to examine the esophagus, stomach and first part of the small intestine (duodenum) with an endoscope. While it is less common for these areas to be involved with Crohn's disease, we may recommend this test if you experience nausea and vomiting, difficulty eating or upper abdominal pain.
  • A capsule endoscopy test is sometimes used to help diagnose Crohn's disease involving your small intestine. You swallow a capsule that has a camera in it. The images are transmitted to a recorder you wear on your belt, after which the capsule exits your body — without pain — in your stool. You may still need an endoscopy with a biopsy to confirm a diagnosis of Crohn's disease.
  • A balloon-assisted enteroscopy exam enables the gastroenterologist to look further into the small bowel where standard endoscopes don't reach. For this test, we use a scope in conjunction with a device called an overtube. This technique is useful when a capsule endoscopy shows abnormalities, but the diagnosis is still in question.

Imaging procedures

  • If you have severe symptoms, your doctor may use a standard X-ray of your abdominal area to rule out serious complications, such as megacolon or a perforated colon.
  • Intestinal ultrasound – ultrasound of the abdomen to assess inflammation in the colon and the small intestine.
  • You may have a computerized tomography (CT) scan — a special X-ray technique that provides more detail than a standard X-ray does. This test looks at the entire bowel and tissues outside the bowel.
  • CT enterography is a special CT scan that provides better images of the small bowel.
  • A magnetic resonance imaging (MRI) scanner uses a magnetic field and radio waves to create detailed images of organs and tissues. An MRI can evaluate a fistula around the anal area (pelvic MRI) or the small intestine (MR enterography). There is no radiation exposure with MRI

How is inflammatory bowel disease treated?

Depending on the type of inflammatory bowel disease, your doctor may use the following medications to reduce inflammation:

  • Antibiotics
  • Anti-inflammatory medications (mesalamine, sulfasalazine), immunomodulators (6-MP, azathioprine, methotrexate), biologics, small molecules, steroids

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    Fondren Inflammatory Bowel Diseases Program

    Underwood Center gastroenterologists are among the nation’s leaders in the treatment and diagnosis of IBD. Explore the program >