Inflammatory bowel diseases (IBDs), including Crohn’s disease and ulcerative colitis, are long-term conditions that affect the digestive system. The chronic inflammation and damage to the lining of the intestine cause severe burden for patients and require close monitoring of the disease state to navigate therapy. Commonly, ultrasound (US) is used to image the abdomen and identify fibrotic tissue, however, determining the inflammatory state remains difficult. Here we aim to enhance US-based IBD diagnostics and monitoring by providing a contrast agent that can report molecular activity of inflammation through US. The contrast agent is comprised of lipid microbubbles that alter the US signal upon interaction with certain enzymes involved in inflammation such that a bright image appears.