Why Is ESR Test Done & How Is It Done? | What Diseases Cause High ESR & What Happens If ESR is High?

An ESR or erythrocyte sedimentation rate test (also known as sed rate test and sedimentation rate test)⁽¹⁾ is not done for any one particular condition but is done to help determine the presence of inflammation. For finding out the cause of any problem many different tests are also done along with ESR test. The ESR test is also done to supervise inflammatory diseases.

If a person has inflammation in the body, then the red blood cells in the body stick together resulting in formation of clumps.⁽¹⁾ The clumping action affects the rate at which the red blood cells sink inside a blood sample test tube. This test helps the doctor in knowing the amount of clumping that has occurred. When there is inflammation in the body it leads to development of abnormal proteins in the blood, which cause the red blood cells to stick together and settle down or sediment in the bottom of test tube more quickly. The more fast and deep down the red blood cells of the blood sink to the bottom of the test tube, the greater the chances of presence of inflammation.⁽¹⁾

The ESR test is done to assess the amount the inflammation present, if any, in the body. The ESR test, however, doesn’t help in finding the cause of the inflammation; only the presence and amount of inflammation. This is the reason the ESR test is done along with other tests to find the cause of the inflammation too.

ESR only helps in finding if there is any inflammation in the body. To find out the cause, other tests need to be done. Conditions causing inflammation in the body are: cancers, autoimmune diseases and various infections.

The ESR test also helps in monitoring of autoimmune inflammatory conditions that include: systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA).

ESR test is also done if the patient has: polymyalgia rheumatica or other connective tissue or muscle problems and some types of arthritis.

You might need an ESR test if you experience symptoms of inflammatory conditions, such as arthritis or inflammatory bowel disease (IBD).

These symptoms can include:

• Joint pain or stiffness that lasts longer than 30 minutes in the morning.
• Headaches, particularly with associated pain in the shoulders.
• Shoulders, neck or pelvic pain.
• Unintentional weight loss.
• GI symptoms, such as stomach ache, blood in stool, fever and diarrhea.

There is very little preparation needed for ESR test. Before undergoing ESR test, your physician should be informed of all the medicines that you are taking. Your physician can tell you to temporarily stop the medicines before the ESR test, as some medications can affect the results of ESR test.⁽²⁾

The ESR test takes only a couple of minutes to be done, as it is only a matter of simple blood draw. The first step is cleaning the area from where the blood sample will be taken. The vein is selected and the skin over it cleaned and a tourniquet is placed above the elbow. Then the technician will insert the needle and draw the blood to be tested. After the needle is removed, a band aid is applied to the puncture site to stop bleeding, if any.

The blood sample is sent to the lab, where it is placed in a thin long tube where it sits to gravity for an hour. Meanwhile, in this hour, the technician will be observing the test-tube to see how many, how far and how soon the clumping of the RBCs occurs.

Along with the ESR test, a C-reactive protein (CRP) test can also be ordered by the doctor.⁽³⁾ The C-reactive protein test also helps in the measurement of inflammation along with predicting the risk for coronary artery disease and other heart diseases.

A simple blood test involving withdrawing of blood has next to zero risks. Some complications which can occur are: fainting, bleeding, hematoma, bruising, inflammation of the vein, infection, lightheadedness and tenderness. Slight pain is felt when the needle pricks the skin. Slight throbbing can also be felt at the puncture site after the ESR test.

There are different conditions that cause a high ESR result. Different conditions related to higher rate of ESR are: pregnancy, advanced age, anemia, obesity, kidney and thyroid disease and some types of cancer.

An abnormally high ESR potentially means the presence of cancerous tumors, particularly if there is no inflammation in the body.^{(4, 6)}

Very high ESR test also means that the patient can be suffering from autoimmune diseases, such as: Lupus, Waldenstrom’s macroglobulinemia; certain types of arthritis, such as rheumatoid arthritis; temporal arteritis; hyperfibrinogenemia; polymyalgia rheumatica; necrotizing or allergic vasculitis.^{(5, 6)}

Infections also cause high ESR test result and these include: heart infections, bone infection, rheumatic fever, systemic infections, tuberculosis and skin infection.^{(6, 7)}

After the ESR test results have arrived, the doctor will decide whether additional tests need to be ordered in order to find out the cause of inflammation. A second ESR test can also be done to confirm the results of the first test.

An ESR result need not necessarily mean it’s a cause of worry. A high ESR can be seen in older individuals, pregnant women and people who are anemic and it is perfectly okay.^{(8, 9)} Otherwise high ESR indicates inflammation in the body due to various medical conditions and treatment is done according to the cause of high ESR.

What the doctor does in case of high ESR is first find out the cause. If inflammation is detected, then nonsteroidal anti-inflammatory drugs need to be given. Corticosteroids are also given to combat the inflammation. If the high ESR is due to bacterial infection, then the patient is prescribed an antibiotic for it.

For more serious conditions that cause high ESR, such as kidney disease, tumors; the patient is referred to a specialist and treatment is done accordingly.

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