Tests That Check for Ulcerative Colitis Remission
Health ConditionsDigestive HealthUlcerative Colitis

Which Tests Check for Ulcerative Colitis Remission?

By
Published on April 22, 2026
by

Next up video playing in 10 seconds

Which Tests Check for Ulcerative Colitis Remission?

Alan Moss, MD, chief scientific officer of the Crohn’s & Colitis Foundation, defines the types of ulcerative colitis remission, and lists the tests that check for each.

The goal of any ulcerative colitis treatment is to help you reach both clinical remission (an absence of symptoms) and endoscopic remission (a healing of the bowel’s mucosal lining).

“People with endoscopic healing have a better chance of doing well in the longer run than those who don’t [have endoscopic healing], which is why we make it a goal,” says Adam S. Cheifetz, MD, director of the center for inflammatory bowel disease at Beth Israel Deaconess Medical Center and a professor of medicine at Harvard Medical School in Boston.

To check for clinical remission, your doctor will first ask you whether symptoms such as bleeding and urgency have resolved. Then, they might recommend one or more of the following tests to assess how your gut is healing:

Endoscopy 

A doctor inserts a thin, flexible tube with a lighted camera into the anus to examine the inside of the gastrointestinal (GI) tract. Two of the most common endoscopy tests for ulcerative colitis include:

Sigmoidoscopy 

The doctor examines the lower third of the colon for signs of inflammation and bleeding. This test can be performed with or without sedation.

Colonoscopy 

The doctor checks the entire lining of the colon for inflammation and bleeding and precancerous or cancerous growths. You will be sedated during the procedure. Compared to a sigmoidoscopy, this test is slightly more invasive and requires more preparation. You usually have to follow a restricted, clear-liquid diet for 24 hours before a colonoscopy.

Your doctor might have recommended an endoscopy when you were first diagnosed, says Dr. Cheifetz, but repeat scopes are often recommended every one to three years to assess disease activity and check for signs of colon cancer.

Biopsy 

A small piece of tissue is collected during a colonoscopy and analyzed in a laboratory. When your doctor first diagnosed you, they may have performed a biopsy to evaluate new GI symptoms. “If somebody is sick, we do biopsies to make sure there’s no concurrent infection,” says Cheifetz. Your doctor might also do a biopsy to check for precancerous growths in the colon.

C-Reactive Protein (CRP) Test 

This blood test reveals how much C-reactive protein, a type of inflammatory marker, is in your blood. It’s not specific to ulcerative colitis, because CRP can be high for many reasons, but the inflammatory marker is often elevated during ulcerative colitis flares. CRP usually goes down quickly after you start taking medication, says Cheifetz. From there, the test is often repeated every 6 to 12 months.

Fecal Calprotectin Test 

The doctor sends your stool sample to a lab to check for fecal calprotectin, a protein that’s often elevated in ulcerative colitis. High levels of fecal calprotectin can signal gut inflammation, which can occur when the immune system sends an influx of white blood cells into the area, releasing calprotectin.

Your doctor might have recommended this test when you were first diagnosed with ulcerative colitis and may have repeated it about three to six months later. That’s how long it usually takes for calprotectin levels to normalize, says Cheifetz. From there, your doctor might repeat this test every 6 to 12 months.

Complete Blood Count (CBC) 

This test measures key blood components, such as plasma, red blood cells, and white blood cells, to spot infections or anemia (low blood count). Anemia is a common complication of ulcerative colitis. It’s often caused by intestinal bleeding and inflammation that interferes with the absorption of the blood-building mineral iron.


Computed Tomography (CT) or Magnetic Resonance Elastography (MRE) Scan 

These tests provide 3D images of the inside of the colon. They can provide additional information about abnormalities spotted on a colonoscopy or serve as an alternative when a colonoscopy isn’t feasible.

A CT scan uses multiple X-rays to produce a picture. MRE uses magnetic resonance imaging (MRI) with low-frequency vibrations to create an image of the gut.

Both tests can help doctors spot and assess inflammation and ulcers in people with ulcerative colitis,  research suggests.

Intestinal Ultrasound 

Ultrasound helps doctors see thickening of the bowel wall, a sign of inflammation. This noninvasive test isn’t commonly used in ulcerative colitis, but some doctors are starting to use it more regularly.

 If the results of any of these tests suggest ulcerative colitis is flaring, your doctor might recommend further testing or adjust your treatment plan.

The Takeaway

  • The goal of ulcerative colitis treatment is remission, meaning symptoms have eased and you’re showing signs of improvement on key medical tests.
  • Your doctor might recommend one or more imaging or blood tests to detect signs of gut inflammation.
  • If the tests suggest ulcerative colitis is not in remission, your doctor might recommend more tests or a change in medication.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Ulcerative Colitis Diagnosis and Testing. Crohn’s & Colitis Foundation.
  2. Flexible Sigmoidoscopy. Cleveland Clinic. September 28, 2023.
  3. American Cancer Society Guideline for Colorectal Cancer Screening. American Cancer Society. January 29, 2024.
  4. Croft A et al. Markers of Systemic Inflammation in Acute Attacks of Ulcerative Colitis: What Level of C-Reactive Protein Constitutes Severe Colitis? Journal of Crohn’s and Colitis. July 2022.
  5. Calprotectin Stool Test. MedlinePlus. January 9, 2024.
  6. Anemia Fact Sheet. Crohn’s & Colitis Foundation.
  7. Magnetic Resonance Elastography. Mayo Clinic. May 29, 2024.
  8. Radmard AR et al. MR Enterography in Ulcerative Colitis: Beyond Endoscopy. RadioGraphics. January 2024.
  9. Dagar M et al. Comparing the Diagnostic Accuracy of Magnetic Resonance Enterography and Computed Tomography Enterography in Inflammatory Bowel Diseases: A Prospective Study. Cureus. November 19, 2025.
  10. Irene M et al. A Comprehensive Guide to Intestinal Ultrasound in Ulcerative Colitis. Best Practice & Research Clinical Gastroenterology. September 2025.
Additional Sources
  • Singh S et al. AGA Clinical Practice Guideline on the Role of Biomarkers for the Management of Ulcerative Colitis. Gastroenterology. March 2023.
Meet Our Experts
See Our Editorial PolicyMeet Our Health Expert Network
ira-daniel-breite-bio

Ira Daniel Breite, MD

Medical Reviewer
Castle Connolly Top Doctor

Ira Daniel Breite, MD, is a board-certified internist and gastroenterologist. He is an associate professor at the Icahn School of Medicine at Mount Sinai, where he also sees patien...

See full bio

Julie Stewart

Author

Julie Stewart is an author and editor with more than a decade of experience in health, science, and lifestyle writing. Her articles have appeared online for Men’s Health, Women’s H...

See full bio
See Our Editorial PolicyMeet Our Health Expert Network